OBJECTIVES: The absolute Cardiovascular Disease (CVD) risk is a leading cause of death. Guidelines recommend treatment with lipid-modifying drugs for patients with an elevated CVD risk, since cholesterol target attainment allows a reduction of events. Our aim was to analyze the economic impact (drugs and hospitalizations) of LDL target attainment. METHODS: A multicenter, retrospective observational study using administrative and laboratory databases (1.1 million health-assisted individuals) was conducted. The enrolment date for a given patient was the last date in year 2009 in which the patient reached its LDL therapeutic target, accordingly to its CVD profile. Patients without statins prescriptions within the 18 months preceding the enrolment date were excluded. RESULTS: A total of 17,243 patients were enrolled (54.6% males, age 69,3±10,0). The annual standard cost for statins and cardiovascular hospitalizations to achieve the therapeutic target, obtained from a multivariable regression model, was €698. The standard annual requirements for welfare benefits, calculated on the basis of this approach, had a value of 14% lower (€2,914,807) than the current value of expenditure. This resource saving was attributable to a reduced spending in hospital admissions, likely due to a correct prevention. The standard requirements, however, showed a different items composition of expenditure; particularly, we observed an increase of the pharmaceutical expenditure by 13% (€1,022,825) compared to the current value. 42% of patients did not reach target (13% adherents, 29% non-adherents), 33% reached target (although non-adherents), consuming 28% of the total expenditure, suggesting an over-consumption of resources (27% used high dosages statins); this expenditure could be reallocated within the non-target groups, increasing the adherence and switching to other statins and/or dosages. CONCLUSIONS: The applicability of this approach and the cost-saving achievement, needs the adoption of a reimbursement system that rewards the care pathway not only in its individual parts (ie, drug treatments).