OBJECTIVES: To evaluate the ability of interactive voice recognition (IVR) technology to improve statin adherence in a cohort of new start patents. METHODS: Plan members were identified based on the existence of a filled prescription for statin therapy between 5/1/2005 and 12/1/2005 and randomized to intervention or control group. Statin prescription claims were evaluated through 6/25/2006 when study analysis was completed. Subjects had to be 18 years or older, continuously enrolled in the health plan for 2 years, and new users of statin therapy. Members enrolled in any other plan-sponsored IVR initiative were excluded from this analysis. The intervention group received three automated phone calls; call one provided disease state education, call two was a refill reminder, and call three addressed the importance of physician follow up. The program provided customized interaction based on patient response, primary vs. secondary prevention, and refill behavior. Persistence and mean possession ratios (MPR) and were calculated at a 3-6 month timeframe for all study participants and compared to usual care. RESULTS: During the 7-month enrollment period a total of 6833 members were randomized to the intervention group for call one, 3274 for call two, 772 for call three, and 4172 to usual care. Members reached for each intervention group were 3723 for call one, 1427 for call two, and 339 for call three. Targeted members demonstrated statistically significant higher rates of persistency compared to the control group (49.2% vs 44.70%). MPRs were also statistically significantly higher for members receiving telephonic intervention at 3-6 months (0.759 vs 0.738). These differences were seen regardless of age and gender. CONCLUSION: Compliance with statin therapy remains poor, however IVR technology can improve adherence to statins in new start patients. Additional studies are needed to evaluate the use of IVR technology in combination with other more traditional compliance methods.