Objective: Recent analyses from randomized clinical trials (RCTs) indicate that, compared to generic simvastatin, atorvastatin treatment results in a reduction of cardiovascular (CV) events during the first year of treatment. This study was conducted to estimate the early clinical and economic consequences of initiating statin therapy with atorvastatin vs. simvastatin from a Canadian societal perspective. Methods: A cost-consequence model was developed to estimate CV events and costs over the first 2 years of treatment associated with initiating atorvastatin or simvastatin in a hypothetical cohort of 100,000 patients. Four groups of new users were considered, including patients with: 1) diabetes; 2) multiple CV risk factors; 3) coronary heart disease; and 4) acute coronary syndrome. RCT data were used to estimate the CV event rate for each statin. CV events included myocardial infarction, stroke, and revascularization procedures. Corresponding direct costs (i.e., health care utilisation, drug) were obtained from the Ontario Drug Benefit and Ontario Case Costing Initiative. Estimates of indirect costs (loss of productivity) were obtained from Statistics Canada. All costs were expressed in 2007 Canadian dollars. Multivariate (Monte Carlo simulation) and univariate sensitivity analyses were conducted on model assumptions. Results: Within two years of treatment initiation, the use of atorvastatin is predicted to prevent 1648 CV events (95% CI: 1343-1956) per 100,000 new patients compared with simvastatin. Similarly, the cost of CV events was reduced by $50.8 million (95% CI: $41.9-$59.8). The incremental cost associated with atorvastatin treatment was $31.3 million. This resulted in a net saving of $19.5 million (95% CI: $10.7-$28.7). Savings were also observed across all four groups considered. Results were sensitive to assumptions regarding simvastatin efficacy and levels of persistence. Conclusion: Based on this model, atorvastatin use is predicted to result in cost savings to the Canadian society over simvastatin use within 2 years of therapy initiation.