OBJECTIVES: To evaluate the cost-effectiveness of one-year treatment with clopidogrel plus aspirin compared to aspirin alone in patients without ST-segment elevation (NSTEMI) from the Greek third-party-payer perspective. METHODS: A Markov model for evaluating the long-term cost-effectiveness of clopidogrel in patients with NSTEMI was adapted and extended by using local utility and economic values. The effect of clopidogrel was applied during the first year in the model and was estimated by the CURE trial. Costs assigned to each health state included antiplatelet treatment cost, cost for the management of adverse events and the costs for concomitant medication, hospitalization, outpatient visits, rehabilitation and nursing. The incremental cost-effectiveness ratio (ICER) was calculated. A probabilistic sensitivity analysis was conducted in order to assess the impact of all uncertain model parameters varying simultaneously. The results are presented as mean (95% Uncertainty Interval (UI)).  RESULTS: The analysis showed a discounted survival of 8.27 (8.25-8.30) years in the aspirin treatment group and 8.42 (8.39-8.44) years in the aspirin+clopidogrel treatment group; a difference of 0.14 (0.11-0.18, p<0.001) years. Adjusting the survival for the quality of life, the model predicts 7.52 (7.15–7.79) and 7.66 (7.27–7.94) discounted QALYs in the aspirin and clopidogrel+aspirin arm, respectively, resulting in a difference of 0.14 QALYs (0.10-0.17, p<0.001). The cumulative lifetime costs per patient were € 15,976 (€14,848–€17.156) and € 15,392 (€14,301- €16,535), for aspirin and clopidogrel+aspirin treatment arm, respectively, a difference of € 584 (€525-€647). The ICER was €4111 (€3342–€5169) for each life-year saved and €4385 (€3487–€5647) for each QALY saved. For a decision threshold of €5500 per discounted QALY, clopidogrel+aspirin is cost-effective in more than 95% of randomly sampled analyses. CONCLUSIONS: Treatment with clopidogrel in addition to aspirin is a cost-effective treatment option in patients with NSTEMI from the perspective of a third-party payer in Greece.