Cost-effectiveness of luseogliflozin for the management of type 2 diabetes mellitus in Vietnam: a Markov model analysis from the Vietnam social health insurance perspective

This study aimed to assess the cost-utility of luseogliflozin compared with Standard of Care (SoC) for patients with T2DM in Vietnam, under two reimbursement scenarios by Vietnam Social Health Insurance (VSHI). A Markov model with five health states was developed to simulate lifetime disease progression. The analysis adopted the VSHI perspective, including only direct medical costs. Health outcomes were expressed as quality-adjusted life-years (QALYs), and cost-effectiveness was evaluated against a willingness-to-pay (WTP) threshold of 1 GDP per capita in Vietnam (USD 4,700 per QALY). Both costs and outcomes were discounted at 3% annually. One-way and probabilistic sensitivity analyses (10,000 iterations), as well as a scenario analysis reflecting the 70% reimbursement case (consistent with the reimbursement rate applied to other SGLT2 inhibitors) were conducted. In the base case (100% reimbursement), luseogliflozin increased total costs by USD 535.38 and yielded 0.325 additional QALYs, resulting in an incremental cost-effectiveness ratio (ICER) of USD 1,649.34/QALY, which is well below the WTP used in this analysis. The probabilistic analysis showed a mean ICER of USD 1,661/QALY, with 100% of simulations confirming cost-effectiveness. In the 70% reimbursement scenario, the incremental cost decreased to USD 327.74, yielding an ICER of USD 1,010/QALY, further strengthening the conclusion of cost-effectiveness. From the VSHI perspective, luseogliflozin was cost-effective compared with SoC, and the results remained robust across all sensitivity and scenario analyses. As the first economic evaluation of luseogliflozin in Vietnam, these findings provide locally relevant evidence to inform reimbursement policy for diabetes treatment.