OBJECTIVES: Glaucoma is associated with elevated intraocular pressure (IOP) which can develop nerve damage and loss of vision. Primary open angle glaucoma (POAG) or ocular hypertension (OH) patients should be treated with lowering IOP that is a major factor in preventing the progression of visual impairment related to glaucoma. Nowadays prostaglandin is recommended as first-line treatment drug for reduction of elevated IOP. The main objective of this study is to evaluate the cost-effectiveness of tafluprost  compared with latanoprost in POAG or OH patients in Korea. METHODS: A decision analytic model was developed from a societal perspective for one year to estimate clinical outcome, drug cost and glaucoma related cost. The model assumes pathways like following: successful treatment, switching to other drug, adding other drug, laser or surgery. Transition probabilities of successful treatment is defined as the percentage of patients with elevated IOP achieving <20% reduction, and transition probabilities of switching is the percentage of patients who were withdrawn due to severe adverse events. IOP reduction rate and transition probabilities were obtained from published literatures searched in database. Resource utilizations and costs were calculated with Korean national health insurance data and clinical expert opinions. Sensitivity analyses were performed on crucial parameters. RESULTS: Tafluprost is more effective and less costly than latanoprost (25.68% vs. 24.76% IOP reduction rate, $603.08 vs. $615.33 expected cost). Thus tafluprost was shown to be dominant compared with latanoprost. The results of sensitivity analysis revealed stable across most of the included parameters. CONCLUSIONS: According to this study, tafluprost shows better clinical outcome for one year than latanoprost. In addition, frist-line treatment of tafluprost is a more cost-effective strategy associated with POAG or ocular hypertension compared with latanoprost.