OBJECTIVES: To quantify potential cost savings and quality adjusted life year (QALY) gains of improving the blood pressure (BP) profile of non-steroidal anti inflammatory drugs (NSAIDs). METHODS: Increasing attention has been paid to the cardiovascular (CV) risk of NSAIDs, partially triggered by the withdrawal of rofecoxib. Small increases in BP associated with NSAID use contribute to the CV toxicity of NSAIDs. OA patients often have an elevated risk for CV events due to characteristics common to this population; advanced age, obesity, and co-morbidities such as diabetes, hypertension and other CV risks. In order to quantify the potential health economic benefits of improvement in the BP profile of NSAIDs, an individual state transition model (one year cycles, 5-year treatment duration, life-time model horizon, healthcare perspective) encompassing eight CV events (congestive heart failure, stroke, transient ischemic attack, myocardial infarction, stable angina, unstable angina, stroke death and MI death) caused or exacerbated by increases in BP was constructed. The model was populated with UK data. The model was used to estimate potential cost savings and QALY benefits from avoided cardiovascular events associated with four levels of relative risk reductions (RRRs) with a hypothetical NSAID (5%, 10%, 15%. 20% and 25%) compared to naproxen – widely regarded the NSAID with the most benign CV profile currently on the market – at three levels of absolute 10-year primary CV risk (20%, 30% and 40%). RESULTS: As expected the cost savings and QALY benefits associated with avoided cardiovascular events increased with the level of RRR and 10-year absolute CV risk. Potential cost savings ranged from GBP 181 to GBP 1,591, whereas the QALY benefits ranged from 0.05 to 0.44.   CONCLUSIONS: An NSAID with an improved BP profile has the potential to provide significant health economic benefits, especially in patients with elevated CV risk.