OBJECTIVES: A comparative cost-effectiveness analysis of generic versions of atorvastatin (atva) and simvastatin (simva) with rosuvastatin (rosva) in patients with primary hypercholesterolemia in the RF. METHODS: This study compared two brands of atva – Atoris (KRKA) and Tulip (LEK), and one of simva – Vasilip (KRKA) with rosva - Crestor (AZ). Efficacy data in terms of percentage reduction in LDL cholesterol and proportion of patients to European LDL cholesterol goals was taken from the STELLAR trial . Price per pack data was obtained in RUR from the wholesale Protek price-list (20.07.2006). Exchange rate is 25.98 RUR per 1 USD and 34.75 RUR per 1 Euro. Meta-analysis of all available comparative clinical trials has shown a relative effective dose of 1:3 for rosva compared with atva and 1:8 for rosva vs simva. Hence cost and efficacy data for rosva 10 mg is compared with atva 30mg (20 mg+10 mg) and with simva 80 mg (40 mg+40 mg) in the form cost per patient per year and cost per patient to European LDL cholesterol goals. RESULTS: The cost per patient to LDL-C goal for Crestor 10 mg is 17,914 RUR, for Atoris 30 mg, Tulip 30 mg and Vasilip 80 mg is 25,968; 25,372 and 27,692 RUR respectively. Within a budget of 10 million RUR the number of patients at European LDL-C goal at 1 year is: 558 on Crestor, 361 on Vasilip, 385 on Atoris and 394 on Tulip. CONCLUSION: Based on the equi-effective dose of statins CRESTOR is shown to be cost-effective compared to atorvastatin and simvastatin even at low generic prices across all value metrics analysed.