Comparative Trends in Statin Utilization and Expenditures in the Public and Private Healthcare Sectors in Malaysia: Insights From the Malaysian Statistics on Medicines, 2004-2022

OBJECTIVES: Malaysia bears a considerable burden of cardiovascular diseases, reporting one of the highest prevalence rates in Southeast Asia. This underscores the need for equitable access to and efficient use of statins, the primary agents in cardiovascular disease prevention in Malaysia's 2-tiered health system. This study compared trends in the utilization, expenditures, and cost per defined daily dose (DDD) of statins in Malaysia's public and private healthcare sectors from 2004 to 2022. METHODS: National aggregate data on simvastatin, atorvastatin, and rosuvastatin were extracted from the Malaysian Statistics on Medicines. Expenditures were adjusted for inflation. Cost per DDD was calculated by dividing inflation-adjusted expenditure by total DDDs consumed. Joinpoint regression was used to describe temporal changes in utilization and expenditure trends. RESULTS: Statin utilization increased in both sectors over the study period, with substantially stronger growth in the public sector. Atorvastatin had the highest growth rate in the public sector with an average annual percent change of 25.27%, whereas rosuvastatin increased most rapidly in the private sector (average annual percent change 13.09%). There were substantial differences in the cost per DDD for the statins between the 2 sectors over the study period. The public sector demonstrated improved cost efficiency over time, whereas the private sector exhibited persistently high expenditures, especially for rosuvastatin. CONCLUSIONS: There were distinct differences in statin utilization and cost burden between the public and private sectors. Targeted measures to promote generic uptake and address pricing disparities are essential to ensure equitable access to statins across Malaysia's 2-tiered healthcare system.