OBJECTIVES: To describe the statins prescriptive patterns in primary or secondary prevention patients, to quantify treatment adherence and persistence and to produce data useful to administrators for better healthcare planning. METHODS: Five pharmacoutilization observational retrospective studies were conducted in five italian Local Healthare Units, using the same methodology and statistical plan. Two databases (Pharmacy Claims and Hospital Discharges) were queried to select subjects with at least one statin prescription during the study period or an hospitalization for ischemic cerebro-cardiovascular causes. Record linkage was carried on using personal tax code as primary key (replaced with an anonymous code to ensure compliance with privacy rules). Subjects were classified in primary or secondary prevention (absence or presence of cerebro-cardiovascular events and/or at least two antidiabetics prescriptions) and in occasional or not-occasional users (time between the first and last prescription was ≤ 28 days or > 28 days). A statin tablet was assumed as treatment unit. Adherence was quantified as MPR (Medication Possetion Ratio): ratio of tablets dispensed during the follow-up and the follow-up duration. Persistence was estimated using "Life Table" and Kaplan-Meier methods. A multiple linear regression model was built to describe adherence predictors. RESULTS: Demographic characteristics of the 5 samples are essentially superimposable. Occasional users vary from 24% to 75%, mainly in younger classes, females and primary prevention. MPR ranges from 39% to 59% and seems better in males and secondary prevention. After 6 months of treatment likelihood to stop therapy varies from 50% to 70% and it is lower in males and secondary prevention. Sex, age, type of cardiovascular prevention, follow-up duration and statin switch absence seem the major adherence predictors. CONCLUSIONS: Adherence and persistence levels with statin therapy are far from optimal values, resulting in failure to maximize therapy effectiveness and healthcare resources investment.