OBJECTIVES: In May 2012, generic atorvastatin has become available in Belgium. This study examines the impact of market entry of generic atorvastatin on Belgian statin market and on cost-effectiveness of statin therapy. METHODS: Using IMS Health data, the Belgian 2000-2011 statin market was analyzed in terms of total expenditure, annual price of statin treatment, and number of patients. Also, a simulation analysis projected market shares in the Belgian statin market from 2012 to 2015 following market entry of generic atorvastatin. This analysis was based on three scenarios regarding the number of patients taking specific statins. Savings associated with an atorvastatin price reduction of 50%-70% were calculated. A literature review of economic evaluations was conducted to assess the cost-effectiveness of generic atorvastatin. RESULTS: Statin expenditure more than doubled from €113 million in 2000 to €285 million in 2011, mainly as a result of higher expenditure on atorvastatin and rosuvastatin. Although the number of patients treated with simvastatin increased by nearly 800% during 2000-2011, the resulting increase in expenditure was partially offset by price reductions due to generic competition and a simvastatin tender. The simulation analysis indicated that atorvastatin will become the dominant product in the Belgian statin market (market share by expenditure of 47%-66% by 2015). Annual savings were projected to attain €108.6-€153.7 million for a 50% reduction in the atorvastatin price and €152.0-€215.2 million for a 70% price reduction. The literature suggests that generic atorvastatin is cost-effective as compared to simvastatin and becomes more cost-effective at higher daily doses. The limited evidence about the cost-effectiveness of rosuvastatin as compared with generic atorvastatin is inconclusive. CONCLUSIONS: Generic atorvastatin is cost-effective as compared to simvastatin, is projected to become the dominant product in the Belgian statin market and is expected to generate substantial savings to health care payers.