In a previous analysis, based on the West of Scotland Coronary Prevention Study (WOSCOPS), pravastatin was demonstrated to lower the risk of cardiovascular disease (CVD) in hypercholesterolemic men, at an economic efficiency that is not prohibitive overall from the perspective of the National Health Service in the UK. For these results to provide guidance to those who set policy in other jurisdictions, they must account for differences among health care systems. OBJECTIVE: The applicability of these findings to the Belgian setting was investigated by integrating the WOSCOPS results and Belgian epidemiological, resource use and cost data. METHODS: The Belgian Interuniversity Research on Nutrition and Health data were used to evaluate the baseline risk factor distribution and to partially validate the CVD exponential regression model derived from WOSCOPS. The rates at which subjects transition for the first time from health to CVD were calculated, assuming the relative efficacy for pravastatin observed in WOSCOPS. The number of transitions avoided were valued in terms of cost savings to the Belgian health care system and life years gained. Resource use and costs were primarily derived from diagnosis related expenditure in a subset of Belgian hospitals. Belgian life table data were obtained and substituted for the Scottish data to account for differences in life expectancy. RESULTS: The cost-effectiveness ratio remains well below USD 25,000 (BEF 37 = USD 1) per life year gained, the bound typically considered as “moderate to strong evidence for adoption and appropriate utilization”. CONCLUSION: Although the precise estimate depends on the specifics of the country, the variation does not have an impact on the treatment decision that the initial study supports.