OBJECTIVES: To determine the most cost-util alternative in the chronic treatment of Osteoarthritis METHODS: A study of cost-utility was performed that used as source of information for efficacy a systematic review of the literature and as source of costs a microcosting was done of each of the states of health of the outcomes expected with chronic treatment. The quality of life was validated by a panel of experts. As analytical tool, a Markov model was used. The alternatives in competence were non-steroid anti-inflammatories and inhibitors of COX-2, as well as Piascledine. As state of health, hemorrhage of the upper digestive tube, acute myocardial infarction, vascular cerebral event and nephropathy were considered. The perspective of the study was the public health services, in this case the Instituto Mexicano del Seguro Social (IMSS); The analysis was performed with a temporal horizon of 10 years, with a 3% discounting rate for costs and effectiveness. The sensitivity analysis was one-way, two-way and probabilistic RESULTS: Piascledine is the alternative that offers more years of life adjusted for quality of life (17.03 QALYs), insofar as the AINE’s offer14.17 QALY’s and the  Cox-2 13.96 QALY’s. The cost per QALY, is lower with Piascledine ($333 USD) in comparison with AINE’s and Cox-2 $3397.00 USD and $2841.00 respectively. Piascledine is dominant over AINE’s and Cox-2. Piascledine offers more net economic benefits and net health benefits independently of willingness to pay.   CONCLUSIONS:: Piascledine is a dominant treatment in the chronic treatment of  osteosrthritis versus AINEs and COX-2