OBJECTIVE: To assess cost-effectiveness of ezetimibe 10mg (EZ10) co-administration with simvastatin versus a simvastatin dose titration strategy in CHD patients who do not attain cholesterol goal (TC < 5 mmol/L) with simvastatin monotherapy. METHOD: A decision-analytic model was developed to project lifetime costs and benefits of lipid therapy. Clinical trial data were used to estimate TC reductions for different treatment strategies. The effect of TC reductions on CHD event rates was estimated using Framingham equations and Hungarian National Statistics data on nonCHD-related mortality. Direct costs of CHD events in Hungary, Hungarian prices for simvastatin and EZ 10 price (based on German EZ10 price) were used to project lifetime costs. The model was run for a population consisting of 138 CHD patients who are currently treated with simvastatin in an observational Lipid Lowering Treatment study conducted in Hungary, and had not reached goal at the TC measurement after minimum 60 days of treatment. RESULTS: For these patients (mean age 62.9 years, 51% male, lipid profile on simvastatin LDL-C 3.55 mmol/l, TC 5.99 mmol/l, HDL 1.44 mmol/l, triglycerides 2.40 mmol/l), EZ10 co-administered with simvastatin compared to simvastatin titration is projected to increase life expectancy by 0.69 years with a discounted C/LY of 14,891€ and the discounted C/QALY’s of 14,827€. CONCLUSIONS: Treatment with EZ10 co-administered with simvastatin for CHD patients not at goal is projected to be a more cost-effective alternative to simvastatin titration which is substantially under the limit C/LY of 30,000€.