OBJECTIVES:   To evaluate the cost effectiveness of Evra in Mexico from the Popular Healthcare System (PHcS) perspective, that is the recently public third-party payer created for self-employed workers and low-income families outside the social security system. METHODS:   We developed a Markov model to assess costs and benefits associated with the use of Evra in 5-yearly age groups Mexican women. Number of pregnancies averted per 100 users was the effectiveness outcome, which was derived from expert panel estimates based on pregnancy probabilities for hormonal contraceptive methods taken from the 2006 National Demography Survey and one international paper. Contraceptive methods cost and pregnancy costs were included in the model at 2009 values. Comparators for Evra were oral contraceptives (OC’s) and monthly injections, although injections only were compared for ages 30-44. A three-year time horizon was used for base-case analysis, but one-way sensitivity analyses was performed to vary the intergenesic interval from one year to five years, using a 5% discount rate. Probabilistic sensitivity analyses were undertaken to incorporate likely distributional properties of key model parameters RESULTS: According to base-case analysis Evra appear as the dominant strategy compared against OC´s. The largest cost-savings (€20,700) were obtained for ages 25–29 where 37 additional pregnancies were prevented, being pregnancy the main cost driver. Comparison between Evra and monthly injections produced ICER estimates in a range from €667 to €2943 per pregnancy averted for 40-44 and 30-34 age-groups respectively. Sensitivity analysis results showed robustness of model parameters. CONCLUSIONS:   Compared with OC’s, Evra represents a more effective and less costly contraceptive method for Mexican women covered by PHcS, while compared with injections, Evra is a highly cost-effective option.