OBJECTIVE: While treatment guidelines recommend lowering cholesterol to target levels appropriate for CHD patients, many remain above goal on current lipid lowering therapy and hence unable to get the maximum benefit of cholesterol reduction. For these patients, a recently published clinical trial showed that ezetimibe co-administration with existing statin therapy gets 72% of patients to NCEP II goal versus 19% among patients continuing on existing therapy. The objective here is to assess cost effectiveness of Ezetimibe 10mg (EZ10) co-administration in CHD patients not attaining goal (LDL-C > 2.59mmol/dL) while on statin therapy (atorvastatin, and simvastatin). METHODS: Decision-analytic model was developed to project lifetime costs and benefits of lipid therapy. Clinical trial data were used to estimate LDL-C reductions for different treatment strategies. Effect of lipid reductions on CHD event rates was estimated using Framingham risk equations and Hong Kong national statistics on nonCHD-related mortality. Direct costs of CHD events and prices for lipid lowering therapy in Hong Kong were used to project lifetime costs. The model was run for a population consisting of all patients on simvastatin and atorvastatin in an observational lipid lowering treatment study in Hong Kong involving patients initiated on a statin and had not reached goal at the first lipid measurement after treatment. RESULTS: Mean age of study cohort of 67 CHD patients was 64.7 (SD10.8) years and 30% were female with mean LDL-C of 3.23mmol/L and TC of 4.85mmol/L. EZ10 co-administered with statin compared to statin titration is projected to increase life expectancy in this patient cohort by 0.45 years with C/LY of $7,387 and C/QALY of $7,362. CONCLUSIONS: Based on the model, treatment with ezetimibe co-administered with statin for CHD patients not at goal is a cost-effective alternative to statin titration and is well below the $45,000 cost/QALY threshold commonly used in these analyses.