OBJECTIVE: To characterize the treatment, and associated costs, of hyperlipidemia in a managed care population. METHODS: All patients within PharMetrics’ Integrated Outcomes Database possessing a diagnosis of hyperlipidemia (ICD-9-CM=272.0, 272.1, 272.2, 272.4) during 1997 were eligible for study inclusion. Patients with less than 12 months of enrollment prior to or following the initial diagnosis, or a prescription claim for a lipid-lowering agent or medical claim for a cardio/cerebrovascular event (CVE) prior to diagnosis, were excluded from the analysis. Patient demographics, hyperlipidemia-specific charges, prescription claims for lipid lowering agents, and comorbid conditions were captured for each patient during the study period. RESULTS: 16,187 patients met the inclusion criteria. The mean age was 51.7 years (SD=11.5), and 59.1% were female. The most common comorbidities were hypertension (35.3 %) and diabetes (12.5%), . Only 21% of patients had a prescription claim for a lipid-lowering agent within 12 months of diagnosis. The most common agents were the HMG-COA reductase inhibitors, prescribed to 3030 patients (18.7%). 239 patients (1.5%) had a CVE within 12 months of diagnosis – the most common of which was atherosclerosis (28.9 %) followed by acute myocardial infarction (4.2%). The incidence of CVEs was positively correlated with age, ranging from 0.8% in patients <55 to 6.52% in patients 80+ years of age. The mean hyperlipidemia-specific charges per patient were $3,047 (SD=7168) for the year prior and $5,260 (SD=13470) for the year following the index diagnosis. For patients having a CVE, the mean total charges were $44,213 (SD=39787). CONCLUSION: Hyperlipidemia represents a substantial cost burden to health systems. Pharmaceutical treatment, despite evidence of its effectiveness, was relatively uncommon in this population.