OBJECTIVES: Increasing real-life adherence to statin therapy is important to achieve the clinical benefits of reducing cardiovascular events (CVEs) reported in randomized clinical trials (RCTs). The aim of this pilot study was to determine the cost-effectiveness of a pharmaceutical care intervention program in community pharmacies, aimed to increase statin adherence for the secondary prevention of CVEs.  METHODS: Meta-analyses of five RCTs were performed to determine the clinical efficacy of statins for secondary prevention, adjusted for different levels of therapy adherence. A Markov model with a lifelong time horizon was developed to estimate the influence of statin adherence on CVEs: stroke, myocardial infarction (MI), revascularization and mortality. Baseline adherence was calculated in a large Dutch prescription database, using the proportion of days covered (PDC) method. The effect of pharmacists’ interventions on statin adherence was derived from literature. A Dutch health care provider’s perspective was adopted; costs and effects were discounted at 4.0% and 1.5% per annum, respectively. RESULTS: Adherence to statin therapy for secondary prevention in The Netherlands was 73.0%. In a cohort of 1000 patients, a 7% increase in adherence resulted in a reduction of 1.9 non-fatal strokes, 0.5 fatal strokes, 7.9 non-fatal MIs, 3.7 fatal MIs and 9.1 revascularizations. Additional medication and intervention costs in the intervention group were €56,000; the cost-savings due to reduced CVEs were €109,000. Overall, the pharmaceutical care program resulted in 53 quality-adjusted life years (QALYs) gained and cost-savings of €53,000.  CONCLUSIONS:   Pharmaceutical care programs in community pharmacies can improve statin adherence for secondary prevention of CVEs. At a reasonable level of intervention effectiveness, the programs resulted in both clinical benefits and cost-savings. The model developed in this pilot study will be used to estimate the cost-effectiveness of a pharmaceutical care program (the MeMO intervention) in the Netherlands that is currently under clinical evaluation.