Objective: To consider the cost-effectiveness of POM statins, OTC statin and plant sterol/stanol products from the perspective of middle aged males when used according to current UK guidance for the primary prevention of CVD. Methods: We used a Markov-Model to obtain the outcomes for an illustrative cohort up to 100 years old or death, whichever come sooner. For the base-case we assumed that all would receive POM statins from 70 years old and all had to pay for their prescription charge up to 59 years. The main outcomes for effects were QALYs (quality-adjusted life-years) and LYG (Life Years Gained). The main costs included were prescription charges, product costs, travel costs and gross weekly incomes. The NICE technology assessment report “Statins for the Prevention of Coronary Events” published in 2005 was used for transition probabilities and utility values. Updated costs for 2007 values extracted from NHS and “HM Revenue & Customs” databases, and average retail prices of the UK market. Results: Estimated discounted incremental cost/QALYs were £2970.63, £8026.37 and £16536.84 for POM statins, OTC statin and plant stanol/sterol products, respectively. Estimated discounted incremental cost/LYGs were £5,339.02, £14,458.69 and £30,076.96, respectively. Cost/QALYs ranged from £1,318.03 to £7,854.44, £4,289.46 to £11,763.28 and £3,961.10 to £29,112.59 for POM statins, OTC statin and plant sterol/stanol products, respectively in the univariate sensitivity analyses. Conclusion: From the patient's viewpoint, the most cost-effective intervention is a POM statin (£2970.63/QALY). There are considerable differences between the most (POM statins) and the least (plant sterol/stanol products) cost-effective interventions. However, for individual patients non-eligibility for free prescription or a strong desire to avoid medicalising disease prevention may overturn the main results.