OBJECTIVES:  To assess the economic impact of adding SevikarHCT® to the Spanish market for the treatment of arterial hypertension in the adult population aged over 35. SevikarHCT® concerns a new three-in-one combination tablet containing olmesartan medoxomil, amlodipine and hydrochlorothiazide. METHODS: To estimate the economic impact a budget impact was developed using the Spanish national healthcare system (NHS) perspective and a 3-year time horizon. The patient population was estimated based on disease prevalence, population growth and data on the currently treated population with combinations of receptor blockers of the antagonists of the angiotensin II (ARBII) with calcium channel blockers (CCB) alone or together with diuretics (DIU) in fixed doses. Costs considered in this model included drugs actually marketed or over the next three years consisting of Balzak®, Balzak plus®, Capenon®, CapenonHCT®, Copalia®, CopaliaHCT®, Dafiro®, DafiroHCT®, Exforge®, ExforgeHCT®, Imprida®, ImpridaHCT®, Twynsta®, Sevikar® and SevikarHCT® expressed in EUR 2010.  Based on the annual drug costs per patient and market shares for each treatment the economic burden before and after the introduction of SevikarHCT® was estimated. A drop of 28% in drug prices was assumed when generic alternatives became available. RESULTS: The Spanish population with arterial hypertension over 35 years treated with combinations of ARBII and CCB with or without DIU was estimated at 990,000 patients in 2010, expecting to rise to 1.17 million patients in 2013. Total treatment costs for hypertension treatment over the next 3 years were estimated at €1.638 million before the introduction of SevikarHCT® and at €1.649 million after introduction. CONCLUSIONS: Although the introduction of SevikarHCT® adds incremental costs for the Spanish NHS, a decrease in the overall economic burden with or without the introduction of SevikarHCT® was observed from 2010. These budget savings can be explained by the effect in price drop caused by the availability of generics.