Pitavastatin (Livalo): A Comprehensive Pharmacological and Clinical Review with Focus on Veterans Affairs Considerations

1. Introduction to Pitavastatin (Livalo / LivaloVA)

1.1. Pharmacological Class and Overview

Pitavastatin, marketed under the brand name Livalo, is a synthetic lipid-lowering agent belonging to the class of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, commonly known as statins.[1] Its primary therapeutic application is the management of dyslipidemia, specifically to reduce elevated levels of cholesterol and other atherogenic lipids in the bloodstream, thereby contributing to the reduction of cardiovascular disease risk.[1] Pitavastatin was developed by Kowa Company, Ltd., a Japanese pharmaceutical company, and is marketed in the United States by its subsidiary, Kowa Pharmaceuticals America, Inc..[4] Statins, as a class, represent a cornerstone in the primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD), and understanding the specific pharmacological and clinical profile of individual agents like pitavastatin is essential for optimizing patient care.

1.2. Contextualizing "LivaloVA" (Pitavastatin and VA Relevance)

The designation "LivaloVA" in the context of this report refers to Livalo (pitavastatin) as it pertains to the U.S. Department of Veterans Affairs (VA) healthcare system. A critical aspect of its status within this system is that Livalo (pitavastatin) is currently classified as "NF Non-Formulary" on the VA National Formulary.[6] This non-formulary status signifies that its prescription and dispensation within VA facilities require a specific non-formulary drug request and prior approval, with a general preference for formulary alternatives when clinically appropriate.[6] For veterans who do receive pitavastatin through the VA system, it falls under Copay Tier 2, as of November 9, 2023.[6]