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Data from an all-Wales survey has shown that only about half of patients at high risk of vascular events take prophylactic aspirin. The Quality and Out-comes Framework (QOF) might be a policy mechanism to achieve the vigorous promotion of the drug for this indication in Wales. In this paper, cautious estimates suggest that NHS hospital cost savings arising from vascular events avoided in Wales might be used to fund the introduction of an indicator into the QOF for four points. The suggested indicator that Welsh health service policy makers may introduce in 2007–08, possibly into the medicines management section of the QOF, might be: 'All patients at increased risk of heart attack and ischaemic stroke not taking low-dose aspirin are encouraged to do so unless contraindications exist'.