OBJECTIVES: The objective of this study was to assess the cost-effectiveness of Xeomin® compared to placebo in the management of cervical dystonia (CD) and blepharospasm (BP) from a Swedish NHS perspective. METHODS: The Country Council in Uppsala requested a cost utility analysis (CUA) be performed to assess the cost-effectiveness of Xeomin® compared to placebo for the management of CD and BP. The economic evaluation uses a Markov model to follow Xeomin® patients through six health states of a Markov process in cycle lengths equivalent to the time between Xeomin® injections (12 weeks). The duration of the model is 16 cycles (192 weeks), consistent with the data sources upon which the model is based. The model includes six broad variables categories: Xeomin® utilisation and cost; resource utilisation and unit costs; utility valuation and QALY calculation; discontinuation; adverse events and discounting. The structure of the economic evaluation is consistent across the two indications. Direct costs were assigned in 16 cycles with the effect on quality-adjusted life years (QALYs), using data from a prospective, open-labelled cohort study. All costs and QALYs accruing after the first year of the economic evaluation are discounted at 3.0% per annum in accordance with the LFN guidelines. Univariate sensitivity analyses were conducted in line with these guidelines. RESULTS: Xeomin® was cost-effective versus placebo, with an incremental cost per QALY gained of SEK 94,317 in CD and SEK 119,182 in BP. Results held under sensitivity analyses. CONCLUSIONS: Xeomin® is a cost-effective treatment option relative to placebo for patients with CD and BP in Sweden. Xeomin® has the added benefits of i) not requiring cold chain storage, and ii) its potential lower immunogenicity.