OBJECTIVES: To evaluate a cost-utility of sertindole compared with commonly used antipsychotic drugs in Poland: haloperidol and risperidone in the treatment of general population of schizophrenic patients and with risperidone in a group of patients intolerant to at least one other antipsychotic agent. METHODS: Cost-utility Markov model was constructed in five-year time horizon. Clinical effectiveness was assessed on the basis of RCTs, meta-analyses, observational studies and systematic reviews. The measures of effectiveness in the CUA were quality adjusted life years (QALY) and life years gained (LYG). Direct medical costs were calculated from perspective of two payers (Polish National Health Fund and patient). Cost of: oral antipsychotic treatment, inpatient care, primary health care, specialist care and adverse events treatment (extrapyramidal symptoms, sedation and weight gain) were included. Discount rates of 5% for costs and 3.5% for benefits were used. Utilities and disutilities associated with AEs and relapse were derived from published literature. RESULTS: In general population of schizophrenic patients cost per QALY/LYG gained, using sertindole instead of risperidone is 97,396/26,585 PLN (€22,507/6,144) respectively; cost per QALY/LYG gained, using sertindole instead of haloperidol, is 82,132/20,670 PLN (€18,980/4,777) respectively. In population intolerant to at least one other antipsychotic agent sertindole dominates risperidone (sertindole is less expensive and more effective considering both QALY/LYG gained). The sensitivity analysis indicated the robustness of the results. Obtained results are placed below the acceptability threshold (3xGDP per capita in Poland) which is about 105,500 PLN (€24,380). The 2009 weighted average exchange rate of Polish National Bank was €1 = PLN 4.3273. CONCLUSIONS: Treatment of schizophrenia with sertindole is a cost-effective strategy in comparison with risperidone and haloperidol therapy. In a group of patients intolerant to at least one other antipsychotic agent sertindole compared to risperidone is dominant strategy.