OBJECTIVES: Poor adherence to cardiovascular therapy is increasingly demonstrated to contribute to poor health outcomes, leading to increased hospitalization rates. This study aims to quantify the potential economic implications of non-adherence to statins in Belgium, from the payer perspective. METHODS: Adherence levels were estimated based on IMS Health Lifelink Treatment Dynamics database (IMS Health LTD). The number of prescription re-fills and total days covered by prescriptions were counted. Patients were assumed to take one pill per day. Dividing the total number of pills by the days of follow-up per patient resulted in the %-adherence level. The number of avoidable hospitalizations corresponding to each adherence level was determined by: the hospitalization risk difference between patients at 80-100% adherence and less than 80% adherence (grouped per 20%, Sokol et al 2005), and multiplying the number of patients in each of the five adherence levels in Belgium (extrapolated from IMS Health LTD according to Pharmanet 2013 report). The total avoidable cost attributable to non-adherence was estimated, by multiplying the number of avoided hospitalizations due to non-adherence with the average cost of a cardiovascular hospitalization in Belgium in 2014 (€5,865), adding the extra drug cost needed to obtain a 80-100% adherence. RESULTS: Sixty-five percent of anonymized patients in the IMS Health LTD were below the acceptable 80% adherence level. A total of 25,716 cardiovascular hospitalizations in Belgium were possibly attributable to lack of adherence to statins therapy. The estimated total avoidable costs related to hospitalization would be €150.8Mn. If all patients raised their levels of adherence to 80-100%, treatment costs with statins would increase with €68.5Mn. Thus, the estimated total amount of savings would be around €82.4Mn. CONCLUSIONS: Correcting poor adherence, not only in the cardiovascular area, can lead to important savings and give air to the healthcare payer to invest in innovative drugs.