OBJECTIVES: Evaluate if the use of Methoxy polyethylene-glycol erythropoietin beta (MPG-beta) offers better health outcomes and costs with respect to erythropoietin beta multidose presentation (50,000 IU) METHODS: Analysis of incremental cost-effectiveness based on a decision tree to simulate the costs of treatment, with a time horizon of 12 months (nominal cost).The monthly dose of erythropoiesis stimulating agents was adjusted according to hemoglobin levels, if the concentration is greater than 12.5 g/dl 10.000 IU/month of erythropoietin beta or 0.6 mcg/kg/month of MPG-beta, for 11 -12.5 g/dl 20.000 IU/month of erythropoietin beta or 1.2 mcg/kg/month of MPG-beta and concentrations below 11 g/dl 40.000 IU/month of erythropoietin beta or 1.5 mcg/kg/month of MPG-beta. Each scenario has a cost based on usual care of these patients. The direct costs were taken from the current rates for 2010 apply to medical services provided by IMSS. We determined the risk of not being in an ideal range of hemoglobin (11-12.5 g/dl), also known as hemoglobin excursions and associated costs. RESULTS: MPG-beta maintains a more stable hemoglobin concentration when compared with erythropoietin beta, so that at 6 months of treatment remain in the ideal range 94% versus 80% with erythropoietin beta. With the use of erythropoietin beta there is a greater risk of having excursions. The incremental cost-effectiveness analysis shows a 13% increase in effectiveness for only an additional $30 USD annually using MPG-beta compared with erythropoietin beta, this derived from the stability of hemoglobin. The ICER is $2.3 USD per incremental percentage of effectiveness. CONCLUSIONS: These results demonstrate that MPG-beta offers better health outcomes against an almost insignificant cost increase being as a cost effective treatment.