In an era of cost-conscientiousness and budgetary restraints, the cost-effectiveness of lipid modulator agents must be considered. The study objective was to evaluate the cost-effectiveness ratio of Lipid Modulator Agents, based on the agents’ effects on the total cholesterol/HDL-cholesterol ratio (TC/HDL-c) and on the cost of acquisition. The choice of TC/HDL-c for the efficacy criterion was dictated by the overwhelming evidence that it is the most predictive parameter in assessing CHD risk, when compared to other lipid/lipoprotein levels or ratios. Also, the evidence supporting the crucial role played by HDL is demonstrated in several studies among which are the Framingham Study. LRC-CPPT, MRFIT and PROCAM. The cost of acquisition of each medication was obtained from the Quebec Provincial Formulary (Liste de Medicament - July 1996). The meta-analysis of each dose of each medication’s effects on TC/HDL was based on a search generating 456 publications from which 124 met the appropriate criteria. From these publications on average, the population is 50.5 years old, with 62.5% males and the baseline TC/HDL=7.3. The various doses of each medication were ranked into 3 categories of efficacy based on the percent decrease of the TC/HDL ratio: less than 20%, 20-30%, and more than 30%. In the most effective category the medications which showed the best efficacy to cost ratio where fluvastatin 60 mg (20% decrease per $ per day) and micronized fenofibrate 200 mg (19% decrease per $ per day) and then simvastatin 20 mg (15% decrease per $ per day).