OBJECTIVE: The study purpose was to evaluate the utility of a patient and prescriber program to increase the use of antilipemics and/or estrogen in at-risk members for CAD. METHODS: Prescription claims from two employer groups were screened to identify surrogate risk factors for the development of CAD based on: nitrates, diabetic claims, tobacco cessation products, and postmenopausal women not receiving estrogen or cholesterol-lowering medications for 1Q98. Patients and providers were sent educational material relating to identified risk and behavioral and pharmacologic treatment options for the prevention/management of CAD. The primary endpoint was increased use of antilipemics and/or estrogen. RESULTS: 3,515/60,241patients were identified with ?1 risk factor (at-risk CAD). Employer A had an at-risk CAD prevalence rate of 9% (90.5% female/mean age 60; men 55 years). Employer B had an at-risk prevalence rate of 16% (69.2% female/mean age 69; men 65 years). The predominant risk factor was postmenopausal status (59%), followed by diabetes (33%) and nitrate use (7.2%). Two or more risk factors were present in 12.3% and 13.8% of Group A and B, respectively. Post-intervention, group A had a 9.2% increase in the utilization of lipid-altering medications (55 on HMG-CoA inhibitors and 71 on estrogen). Group B witnessed an increase of 5.6% (89 on HMGs and 32 on estrogen). Of patients with three risk factors, group A had a 42% initiation rate while group B a 33% rate. CONCLUSIONS: An educational campaign toward patients and prescribers resulted in meaningful increases in lipid-altering medication use. Patients with assumed highest risk had the greatest increase in utilization. Enhanced education is a cost-efficient method for improving utilization.