Objective: To evaluate the health care costs of a physician-pharmacist collaborative care (PPCC) over usual care (UC) for patients at moderate (MR) or high risk (HR) of coronary heart disease with dyslipidemia. Trained community pharmacists provided advance care including monitoring of laboratory tests and lipid-lowering medication dosage adjustments. Methods: Annual direct health care costs and incremental costs were estimated from an interim analysis of a 3-year cluster randomised controlled trial (TEAM study) evaluating the efficacy of a PPCC versus UC for patients on a statin but not at lipid targets. The mean annual costs of pharmacists' follow-up (pharmacists' training, pharmacist visits, laboratory tests), physicians' follow-up (physician visits, laboratory tests), lipid-lowering treatment (medication, pharmacists' fee), and total cost (pharmacists' follow-up, physicians' follow-up, lipid-lowering treatment) were compared between groups by t-tests. Results: Geographical clusters of general practitioners (GP) and pharmacists were randomised to PPCC (GP=41; pharmacists=58) or UC (GP=36; pharmacists=46) and followed 167 patients (PPCC=67; UC=100). Costs for the pharmacists' follow-up per patient were CND$390.80 and CND$410.53 for MR and HR, respectively, including CND$320.67 per patient for the pharmacists' training. Total costs per PPCC patient were significantly higher than for UC patient (MR: 9CND$25.84 vs. CND$529.39; HR: CND$1065.39 vs. CND$591.48). Incremental costs per patient for the physicians' follow-up were: CND$33.38 (p=0.004) for MR and CND$16.17 (p=0.07) for HR, and for the lipid-lowering treatment, CND$39.04 (p=0.6) for MR and CND$79.69 (p=0.06) for HR. Incremental total costs per patient were CND$396.45(p<0.0001) for MR and, CND$473.91 (p<0.0001) for HR. Assuming an incremental efficacy of 10% LDL reduction between groups, ICERs per patient(95% CI) would be CND$39.65 (2CND$1.35 to CND$57.94) for MR and CND$47.39(CND$38.54 to CND$56.24) for HR per % LDL reduction. Conclusion: Community pharmacists can provide advance care to patients with dyslipidemia at a reasonable cost and contribute to reduce the GP workload.