OBJECTIVES: New treatment modalities may improve health outcomes but are usually associated with substantial cost and budget impact, thus limiting the number of patients that may benefit from them. An alternative is implementing a substantially lower cost intervention to a much wider population, accepting inferior per-patient outcomes. We examined whether this approach can provide better outcomes under a pre-specified budget constraint. METHODS: We used the results from the JUPITER trial (Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin) and the United-States target population as a case study. The target population is estimated at 6,700,000 patients: women >60; men >50, with normal LDL but elevated high sensitive C Reactive Protein levels. We built a model that can compare the outcomes on the entire intended-use population, and compared three treatment alternatives: 1) Rosuvastatin for a limited patient population, with the clinical effect reported in JUPITER; and 2) Lowest cost statin for most patients, with 75% of the JUPITER effect per patient; and 3) Usual care (do-nothing) as a baseline for cost and effectiveness. We used a budget constraint of $200M per year, which covers the lowest cost statin for 75% of the target population, and used a 5-year horizon, during which a potential of 268,000 Cardiovascular adverse events could be prevented. RESULTS: The budget allows for 3% of the target patient population to be treated with Rosuvastatin, which resulted in prevention of 7229 cardiovascular events as compared to usual care. Using the lowest-cost statin allows for 75% of the target patient population to be treated results in preventing 118,555 cardiovascular events and is cost-saving compared to usual care. CONCLUSIONS: Under budget constraints, using lowest-cost statins enables a substantially larger market access to treatment, which according to our model resulted in significantly better health outcomes for the intended-use population.