There is now good evidence to support the use of HMG-CoA reductase inhibitors in the primary and secondary prevention of coronary heart disease (CHD). It is thought that the maximum benefit of such treatment can only be obtained with life-long treatment. Since these drugs are expensive, their use is now being scrutinised from a cost-effectiveness point of view, as discussed at the 18th Congress of the European Society of Cardiology (ESC) [Birmingham, UK; August 1996]. As a comparison, the cost-effectiveness of tocopherol [vitamin E] in people with proven atherosclerosis was also discussed.