OBJECTIVES: To assess the health consequences and costs of lack of adherence to National Institute for Health and Care Excellence (NICE) guidelines on the prescribing of statins for the primary prevention of cardiovascular disease in the United Kingdom. METHODS: Value of implementation methods are applied to consider Quality adjusted life years (QALYs) lost and net monetary benefit lost due to the lack of adherence to NICE guidelines using data on current prescribing patterns of statins in the UK and data on the size of the total population currently recommended to receive statins by NICE guidelines. The study considers the value of improving implementation of statins in patients recommended to receive statins and the costs of over prescribing statins to patients currently not recommended to receive statins by current guidelines. RESULTS: The under prescribing of statins in patients recommended to receive statins is substantial with substantial consequences in terms of QALYs. The net momentary value of these lost QALYs is in excess of 1 billion per year. Equally there is currently wide scale overprescribing of statins in patients who are not currently recommended to receive by statins. The total costs to the NHS of this over prescribing are between £101 million and £128 million per annum, with uncertain benefits in terms of cardiovascular events prevented and uncertain cost-effectiveness. CONCLUSIONS: Lack of adherence to NICE guidelines on the prescribing of statins for the primary prevention of cardiovascular disease has significant consequences both in terms of health and NHS budgets. There is considerable value to be had from programs aimed at encouraging greater adherence to NICE guidelines on the prescribing of statins.