While treatment guidelines recommend lowering cholesterol to target levels, many remain above goal (LDL-C>100 mg/dL for CHD/diabetic patients and LDL-C>130 mg/dl for other non-CHD high risk individuals). OBJECTIVE: To assess the change in LDL-C and goal attainment rates due to switching patients to an Ezetimibe/Simvastatin dose titration strategy, compared with a simulated statin monotherapy dose titration strategy. METHOD: A decision-analytic model was developed to project goal attainment at end of 1-year after therapy change. Clinical trial data were used to estimate LDL-C reductions for different treatment strategies. The model was run for a population of 504 Spanish patients (237 CHD/diabetic and 267 non-CHD high risk patients) that had not reached LDL-C goal levels 3-months after starting statin therapy. Patients not at goal where up titrated (till goal attainment or to the maximum dose whichever was first) every 3 months both in the Ezetimibe/Simvastatin (only simvastatin titrated) and in the statin monotherapy titration arms. RESULTS: Mean age was 60.8 (SD 9.8) years, 47.8% female, lipid profile (mg/dl) at three months on statin monotherapy was LDL-C 182.3 (SD 35.1), TC 262.1 (SD 39.5), HDL-C 50.8 (SD 14.1), triglycerides 150.1 (SD 82.5). Ezetimibe/Simvastatin therapy is projected to achieve a 82.6% goal attainment rate, compared with 46.0% projected for the statin titration strategy. With respect to LDL-C reductions, Ezetimibe/Simvastatin would achieve a 38.2% reduction over baseline, compared with a 24.5% with the statin titration strategy. In the statin arm, 73.9% of the patients reached the statin maximum dose, whereas in the Ezetimibe/Simvastatin arm, only 23.5% of the patients did so. CONCLUSION: Compared to statin monotherapy titration, switching patients not at goal on statin monotherapy to Ezetimibe/Simvastatin followed by titration is projected to get 36.6% additional patients to goal and reduce LDL-c by 13.7%.