OBJECTIVES: To evaluate common therapeutic alternatives (rosuvastatin, atorvastatin, simvastatin, pravastatin) for the prevention of primary and secondary cardiovascular events in Greece. METHODS: A Markov model with distinct health states (no event, fatal/non fatal acute myocardial infarction (MI), fatal/non fatal stroke, post-MI, post-stroke & all cause death) was developed, to reflect within a 20-year time span health and economic outcomes of non-smoking patients assumed to be at base line at mean age of 70 years, with no prior treatment of hypertension, systolic blood pressure at 140mmHg and total cholesterol at 260mg/Dl. The HellenicSCORE risk score equation was used to transform systolic blood pressure reductions in different medications into long-term reductions in cardiovascular events. Transition probabilities from acute myocardial infarction or stroke to death were obtained from the Framingham study. Treatment cost was estimated from a payer perspective and includes the cost of medication and all resources used in the management of events. Health states were associated with local quality of life data to estimate Quality Adjusted Life Years (QALYs). A  probabilistic sensitivity analysis was conducted to deal with uncertainty. Prices reflect 2011 and outcomes were discounted at 3.5%. RESULTS: For males, discounted QALYs were: 10.18 (95%CI:10.11-10.23), 10.04 (95%CI:9.96-10.10), 9.94 (95%CI: 9.84-10.02) and 9.88 (95%CI: 9.76-9.97) for rosuvastatin, atorvastatin, simvastatin and pravastatin, respectively. The mean total cost was: 15,646 (95%CI:15,173-16,130), 16,678 (95%CI:16,184-17,187), 17,242 (95%CI:16,732-17,766) and 17,585 (95%CI:17,060-18,119) respectively. For females,  QALYs were: 10.33 (95%CI:10.28-10.37), 10.26 (95%CI:10.20-10.30), 10.20 (95%CI:10.13-10.25) and 10.16 (95%CI: 10.08-10.22), respectively. Similarly, mean total cost was: 15,030 (95%CI:14,632-15,430), 15,608 (95%CI:15,192-16,023), 15,951 (95%CI:15,521-16,379) and 16,153 (95%CI:15,714-16,591) respectively. Hence rosuvastatin was a dominant therapy option. CONCLUSIONS: Rosuvastatin may represent an attractive option relative to alternative therapies,  from an economic and clinical point of view, in the primary and secondary prevention of cardiovascular events in the National Health Service of Greece.