OBJECTIVES: To estimate the cost-effectiveness of closing the statin ‘treatment gap’ in the secondary prevention of coronary artery disease (CAD) in Australia. METHODS: We developed a decision-analysis Markov model with yearly cycles and the following health states: ‘Alive’ and ‘Dead’. Using data from the Australian Reduction of Atherothrombosis for Continued Health (REACH) registry, the model compared current statin coverage (82%) in the secondary prevention of CAD (‘Current’ group) with a hypothetical situation of 100% coverage (‘Improved’ group). The 18% gap was filled with use of generic statins. Data from a recent meta-analysis were used to estimate the benefits of statin use in terms of reducing recurrent cardiovascular events and death. Government-reimbursement data from 2011 was used to calculate direct healthcare costs. The cost of the intervention to improve statin coverage was assumed to be $250 per person. Years of life lived and costs were discounted at 5% annually. RESULTS: Among the 2058 subjects in the ‘Current’ group, the model estimated that there would be 106 non-fatal myocardial infractions, 68 non-fatal strokes and 275 deaths over five years. In the ‘Improved’ group, within which all subjects took statins, the corresponding numbers were 101, 65, and 259, equating to numbers needed to treat of 426, 639, and 127, respectively. Over the five years, there would be 0.018 life years gained (discounted) at a net cost of AUD $546 (discounted) per person. These equated to an incremental cost-effectiveness ratio (ICER) of AUD $29,717 per life year gained. CONCLUSIONS: The results suggest that for patients with CAD, maximizing coverage with statins, in line with evidence-based recommendations, represents a cost-effective means of secondary prevention.