OBJECTIVES : To assess the cost-effectiveness of Rosuvastatin in the treatment of hypercholesterolemia under the Brazilian Public Health Care System (SUS) perspective. To estimate the budget impact of introducing Rosuvastatin into the current Brazilian national drug formulary. METHODS : A Monte Carlo simulation was used to analyze the costs and consequences of treatment with rosuvastatin and atorvastatin. The effectiveness of statins in low-density lipoprotein (LDL) reduction was obtained using clinical data from published systematic review. We used the log-normal distribution for costs using government prices (in Brazilian reais -BRL). The temporal horizon used is 1 year. Using the Healthcare System database we described the evolution of consumption of statins in Brazilian Health System. Univariate and probabilistic sensitivity analysis tested model robustness. RESULTS : The Rosuvastatin is cost saving when compared to atorvastatin, (BRL$215,46 per patient), having an incremental cost-effectiveness ratio (ICER) of BRL$116,84. These results are expected, as rosuvastatin is cheaper and more efficacious than atorvastatin. For a willingness to pay of BRL$30,00/percentual reduction in LDL, rosuvastatin 10 mg should be chosen as more cost-effective in 75% of the cases when compared to atorvastatin 20 mg. The budget impact analysis showed that introduction Rosuvastatin into formulary drug could generate minimum savings of the total budget BRL $10 millions/year (US$4.18 millions dollars). CONCLUSIONS : The Rosuvastatin is the statin more cost-effective than Atorvastatin in treatment of hypercholesterolemia to patients that need high reduction in LDL. Their inclusion into Brazilian National Drug Formulary is cost saving and is aligned with the health authority strategy of cost containment or reduction for this class of medicines.