Objective: To analyse the cost-minimization of Everolimus in comparison with Sirolimus for immunosuppression in kidney transplantation. Methods: A cost-minimization analysis from the Brazilian National Health system perspective, with a time horizon of seven years were conducted. A decision tree with a Markov chain considering the probabilities of graft loss or maintenance through health states related to presence or absence of any relevant health event, were performed. Study comparators examined were Everolimus (EVE) and Sirolimus (SLR). The clinical aspects regarding benefits and probabilities of transition data were extract from meta-analysis of published randomized clinical trials for the alternatives. The analysis is based on Brazilian current clinical practice. Treatment costs were collected from public reimbursement list. Costs and benefits were validated by a panel of Brazilian specialists from Ministry of Health through the Delphi technique. The discounting rate was 5% for costs and benefits, the results were converted in US Dollars (R$1.8/USD$1.00). A one-way sensitivity analysis was performed. Results: Patients using Everolimus get the lowest total cost per treatment (EVE=$15,347.58USD; SLR=$29,959.6USD). The sensitivity analysis on costs variables in an interval of±80%, was robust with the base analysis Conclusion: Everolimus is a cost-saving alternative for immunossuppresion in kidney transplantation compared to Sirolimus in the perspective of Brazilian Public Health System.