OBJECTIVES: To compare baseline characteristics and dosage patterns among Japanese patients newly started on statin.    METHODS: Patients ≥18 years were identified between June 2006 to August 2010, with a minimum 6-month pre- and 12-month post-index health plan eligibility from the Japan Medical Data Center Database. A 90-day statin-free washout period was applied to identify patients in whom statin therapy was newly prescribed. The index date was defined as the date of the first statin prescription. Five cohorts were created based on index statins [atorvastatin (ATS), simvastatin (SIS), rosuvastatin (ROS), pitavastatin (PTA), and pravastatin (PRS)] comparing demographics, comorbidities, statin dosage patterns, prior medication, health care costs and resource utilization.   RESULTS: There were 14,675 patients identified across 5 cohorts: 27.7% ATS, 6.4% SIS, 26.9% ROS, 12.9% PTA and 26.0% PRS. PTA cohort had more diabetes (PTA 14.0% vs. ATS 10.2%, SIS 6.5%, ROS 12.8%, PRS 9.6%) and coronary artery diseases (PTA 8.6% vs. ATS 7.7%, SIS 4.1%, ROS 7.4%, PRS 7.3%). ROS cohort had more prior peripheral vascular disease (ROS 6.6% vs. ATS 5.6%, SIS 3.6%, PTA 5.6%, PRS 5.5%), cerebrovascular disease (ROS 7.0% vs. ATS 6.6%, SIS 2.9%, PTA 5.7%, PRS 6.3%), and hypertension (ROS 33.2% vs. ATS 30.2%, SIS 27.4%, PTA 30.9%, PRS 30.2%). SIS cohort had more prior outpatients visits (SIS 9.6 vs. ATS 8.2, ROS 8.7, PTA 8.2, PRS 9.3). Prior healthcare costs were similar across 5 cohorts. Majority of patients were prescribed lower statin doses: ATS, 10mg (60%); SIS, 5mg (86%); ROS, 2.5mg (89%); PTA, 1mg (49%); PRS, 10mg (62%).  CONCLUSIONS: Japanese patients newly started on a statin had similar prior health care costs, and were prescribed lower doses compared to Western countries. Patients with diabetes and coronary artery diseases were more likely to be prescribed PTA.