With the clinical effectiveness of HMG CoA reductase inhibitors (statins) now well established, pharmaceutical companies' thoughts increasingly turn to highlighting differences within the class - clinical, pharmacological and economic. Several studies presented at meetings over the last few months suggest that some newer statins are more cost effective than older members of the class. Nevertheless, a recent paper emphasises that, for primary prevention at least, the issues preventing wider statin prescribing may be more fundamental than relatively minor differences in cost effectiveness.