OBJECTIVES: Drug therapy should be appropriately prescribed and administered in order to efficaciously prevent cardiovascular events. The study aim was to describe the prescriptions of statins in terms of persistence and compliance with the purpose of identifing appropriate pharmaco-epidemiological indicators close to clinical practice. METHODS: Statins (ATC C10AA) prescriptions data were collected from administrative databases in two Local Health Units (LHUs) in Northern Italy. Eligible patients should have had at least one statin prescription in three consecutive years (2004-2006). The adopted indicators for drug utilization included: “Calendar Days (CD)“, calculated as the difference between the last and the first prescription dates in each year; “PDD days (PDDd)”, calculated as the ratio between total mg prescribed  and the surrogated prescribed daily doses; “DDD days (DDDd)”, calculated as the ratio between total mg prescribed and the defined daily dose. A Compliance to Therapy Index (CTI) was calculated as the ratio between the total PDDd and the CD: indexes were calculated for each patient and classified in four compliance categories (≤ 25%, >25% & ≤ 50%, 50% & ≤ 75%, >75% & ≤ 100%). RESULTS: Indicators showed an increase in statins use over the study period in terms of both DDD and sPDD. Persistence to therapy for at least two years was around 50% in both LHUs. PDDd was a more reliable measure of the daily dosage in comparison with DDDd, which resulted in a coverage period longer than the CD. CTI analysis showed a decrease in low compliance categories (patients in the range 25%-50% decreased from 26% to 17%) and a raise in the rate of compliant patients (from 48% to 57%). Single prescriptions increased from 1% to 5%. CONCLUSIONS: Although statins’ use is steadily growing, poor patients’ persistence and adherence to therapy would need the implementation of strategies to improve compliance with lipid lowering medications.