OBJECTIVES: To investigate the cost-effectiveness of ranibizumab in relation to verteporfin photodynamic therapy (PDT), pegaptanib sodium and best supportive care (BSC) for the treatment of Age-Related Macular Degeneration (AMD) at varying disease states in the Greek healthcare setting. METHODS: A six-state Markov model was constructed according to patient visual acuity in the better seeing eye. Data on effectiveness were derived from randomized controlled trials comparing the outcomes of ranibizumab 0.5 mg administered over a 2year period (8 injections in the first year of treatment, 6 in the second) versus other alternative comparators for the treatment of AMD patients with predominantly classic (PC) lesions and versus BSC and pegaptanib for those with minimally classic (MC) or occult lesions. Resource utilization reflected the Greek healthcare setting and was defined via a panel of experts. Economic and clinical outcomes were estimated over a 10year timeframe from the perspective of a third-party payer (social insurance fund), discounted at 3.5% per annum RESULTS: the estimated mean 10-year direct treatment cost in the ranibizumab arm ranged from €24,844 to €32,931 with a projected benefit of 4.50–4.74 Quality Adjusted Life Years, depending on type of lesion. For PC lesions, the cost per QALY gained with ranibizumab was estimated at €10,037, €19,152 and €3,759 relative to PDT, BSC and pegaptanib, respectively. The corresponding ratios for patients with MC lesions were €28,201/QALY and €19,018/QALY for ranibizumab relative to BSC and pegaptanib, whereas for patients with occult lesions were estimated at €23,976/QALY and €39,696/QALY respectively. The probability of ranibizumab being cost-effective at the €30,000/QALY threshold was  92.6%, 83.0% and 100% (PC lesions), 67% and 87% (MC) and 75% and 42% (occult) for the above presented ICERs. CONCLUSIONS: ranibizumab may be a cost-effective option for the treatment of AMD compared to selected alternatives in the Greek healthcare setting.