OBJECTIVES:  To investigate the prescribing of hypolipidaemic agents with specific emphasis on the effect of generic prescribing on HMG-CoA reductase inhibitor (statin) costs. METHODS: A retrospective, cross-sectional pharmacoepidemiological study was conducted on 2011 medical insurance claims data in South Africa. RESULTS:  A total of 4805 patients (56.88% males) were prescribed 38373 hypolipidaemic agents.  The average age of patients was 56.07 (SD=13.32) years.  Statins accounted for 93.85% of all prescriptions and 83.44% of cost, followed by fibrates (3.61% of prescribing frequency and 7.72% of cost).  Simvastatin was the most frequently prescribed statin (accounting for 62.59% of all prescriptions), followed by atorvastatin (17.04%) and rosuvastatin (11.68%).  Simvastatin was also the active ingredient with the lowest average cost per product of R46.43.  Simvastatin was prescribed under 16, atorvastatin six and pravastatin four different trade names.  Fluvastatin, lovastatin and rosuvastatin only had one trade name under which they were prescribed.  Only one cholesterol absorption inhibitor drug was prescribed (ezetimibe) accounting for 1.64% of prescriptions.  This product had the highest average cost per prescription of R416.37.  Other hypolipidaemic agents prescribed accounted for only 0.89% and consisted of the combination of ezetimibe and simvastatin, and cholestyramine.  The fibrates constituted 3.61% of prescribing, with most prescriptions for bezafibrate.  Dosages for the statins were investigated and it was found that the average Prescribed Daily Doses (PDDs) were generally lower or in agreement with the Defined Daily Doses (DDDs).  The average PDD of simvastatin was 23.70 (DDD=30 mg), pravastatin 25.35 mg (DDD=30 mg), lovastatin 26.31 mg (DDD=45 mg), atorvastatin 20.91 (DDD=20 mg) and fluvastatin 57.29 mg (DDD=60 mg). CONCLUSIONS:  There are a variety of generic equivalents available for the statins on the South African market.  It was clear that products with more generic equivalents had a lower average cost per prescription compared to the innovator products.