OBJECTIVES: Rosuvastatin, a new HMG-CoA reductase inhibitor has been shown to significantly reduce LDL cholesterol. The objective to this analysis was to assess the cost-effectiveness of rosuvastatin compared to all statins currently available in Greece. METHODS: A cost-effectiveness model was developed to compare rosuvastatin with atorvastatin, pravastatin, simvastatin and fluvastatin over 52-weeks, from the perspective of the Greek health care system. Effectiveness was defined as the percentage of patients reaching European targets and was derived from a simulation of clinical trials data. Clinical practice patterns were derived from a survey among lipid treatment hospital centers. Patients received a 12-week prescription of the licensed starting dose. If LDL-C exceeded the target (3.0mmol/L), patients are titrated to a higher dose of statin every 12 weeks until they achieve target or the maximum dose is reached. Patients reaching target (responders), remain at the last prescribed dose, followed-up every six months. Only direct medical costs were included. However, Greek patients can freely use public or private providers, so both public and private charges were used. Drug cost estimates are based on rosuvastatin expected, and on other statins' current, ex-factory prices. Budgetary impact estimates were based on a hypothesized rosuvastatin market share. RESULTS: More rosuvastatin-treated patients reach target with the starting dose. Rosuvastatin patients need fewer up-titration visits and incur lower costs per responder in their first year of treatment compared to atorvastatin, pravastatin, simvastatin and fluvastatin. Rosuvastatin is more effective and less costly across the available dose ranges. For a cohort of 10,000 patients, if rosuvastatin where to have a 25% market share, the model calculates that there would be 642 additional responders, reducing annual costs by €728.204,72 and €83.372,08 in private and public charges respectively. CONCLUSIONS: Rosuvastatin has been demonstrated to be more effective and a potentially cost-saving therapy for Greek patients.