OBJECTIVES: The objective of this investigation was to compare the contrasting results of recent cost-effectiveness analyses of statins. METHODS:  A systematic review of the literature on statin cost-effectiveness was conducted as per Cochrane methodology. RESULTS: The four studies that met inclusion criteria reported variable conclusions about the cost-effectiveness of statin treatment, without a clear unanimity as to whether statins are cost-effective for primary prevention. All studies analyzed health care costs from the health care system perspective – inclusive of and limited to all direct medical costs to all payers resulting from the statin therapy. The time horizon varied from as 5 years to lifetime. Annual drug prices ranged from $770 to over $1,500 in 2006 dollars. The studies reported varying assessments of the cost-effectiveness of statins. Costs ranged from $590,000 to $3 to extend life by one year. Recently published studies found statin therapy more likely to be cost-effective. However, when each study’s assumptions about statin costs were accounted, a substantial agreement among the authors was observed. Studies which assumed statins to be more costly found them to be less cost-effective, and vice-versa. Moreover, treatment of the lower risk groups appeared cost-effective as statins became cheaper. The studies were appraised using Philips and NICE checklist (qualitatively) and Quality of health economic studies (quantitatively). The studies were found to be of average quality. CONCLUSIONS: As the statins become generic, the chances of the patients at low risk for coronary disease may be treated cost-effectively increases.  It would be thus reasonable for clinicians to treat low-risk patients and statin therapy for a broader patient base, based on cost-effectiveness.