longterm economic outcomes associated with intensive versus moderate lipidlowering therapy in coronary artery disease results from the treating to new targets tnt trial background in 10001 patients with stable coronary artery disease cad enrolled in the treating to new targets tnt trial 80 mgd of atorvastatin highdose regimen reduced the composite primary end point of death from cad nonfatal myocardial infarction resuscitation from cardiac arrest or stroke by 22 relative to 10 mgd lowdose regimenmethods we performed an economic analysis of this trial from the us perspective using hospital bills and medicare physician fees to estimate costs for cardiovascular hospitalizations in all us patients n 5308 atorvastatin costs were assigned using a discounted average wholesale price costeffectiveness was calculated as the withintrial incremental cost required to prevent one primary end point event with highdose atorvastatinresults during a mean 49year followup the highdose arm had fewer potential end point cardiovascular hospitalizations 35 vs 41 p 001 and revascularization procedures 16 vs 22 p 001 the highdose regimen was 1 per day more expensive at the end of 5 years cumulative incremental cost for the highdose arm was 252 95 ci722 to 1276 with an absolute reduction in the primary end point of 28 per 100 treated with the highdose regimen the cost to prevent one additional primary end point event was 8964conclusion highdose atorvastatin treatment of 5 years had only a small net incremental cost because of reduced complications and procedures the cost to prevent one additional primary end point event with highdose therapy was similar to that for drugeluting stents versus bare metal stents in stable cad and for early invasive versus early conservative therapy in acute coronary syndromes