OBJECTIVES: To evaluate the direct costs related to recurrence of inguinal hernia repair, in patients who underwent the surgery with PHS versus Polypropylene mesh, under the Brazilian private payer perspective. METHODS: A decision model was developed to assess the costs and resource usage for the recurrence of inguinal hernia repair with the PHS versus Polypropylene mesh under the private payer perspective, based on Brazilian guidelines for HTA (Vianna, 2007). The study was based on clinical data published by AWAD 2007, showing PHS device has lower recurrence rate compared to Polypropylene mesh (0.6% versus 2.7%, p=0.04) in 17 months. The recurrence rate was projected to 60 months (PHS 2.1%; Polyprolylene mesh 9.2%) to evaluate clinical and economic long-term impact. The average incidence rate of 2% for inguinal hernia was based on Brazilian specialist’s opinions. The econom impact of recurrence was calculated considering 200.000 patients. Procedure costs, hospital stay, devices costs and medical staff fees were obtained from Brazilian public lists (CBHMP 4a. ed., Boletim Proahsa and SIMPRO). According to local guidelines, 5% of discount rate was adopted. One-way sensitivity analysis was performed to verify the robustness of the results. RESULTS: According to the model, 108 patients will need reintervention in the Polypropylene mesh group versus 24 in the PHS group in 17 months, representing 74% on reoperation reduction. In 60 months, 368 patients will need reintervention in the Polypropylene group versus 84 in the PHS, 77% reoperation reduction. There was a positive impact of recurrence in the PHS group of R$ 105,401 for a 17 months period (R$ 100,382 discounted) and R$ 355,821 for a 60 months period (R$ 292,730 discounted). CONCLUSIONS: Findings suggest PHS as a safe and efficient alternative for inguinal hernia repair when compared with Polypropylene mesh and can generate resource economy under the payer perspective in Brazil.