OBJECTIVES: The overall cost of care for patients with schizophrenia can increase considerably, due to management of diseases related to the metabolic syndrome such as coronary heart disease (CHD) and diabetes. In the STAR study, aripiprazole is a second-generation antipsychotic that has shown relatively less adverse metabolic effects than other antipsychotics.  The objective of this study is to estimate the avoided cost of CHD and diabetes with the use of aripiprazole compared with the standard of care (SOC) treatment (olanzapine, quetiapine and risperidone) in Mexico. METHODS: Predictions of avoided diabetes and CHD for patients receiving aripiprazole or SOC were based on risk factor data on metabolic outcomes from the STAR study and related published articles. These calculations were applied to the Mexican population considering a schizophrenia prevalence of 0.7%.  The annual cost per patient for the treatment of diabetes and CHD in Mexico was obtained from the literature review indexed to 2009 prices using the national consumption index for health. Cost calculations were discounted by an annual rate of 3.5% and expressed in US dollars at an exchange rate of $13.53 Mexican pesos per dollar. RESULTS: The estimated number of avoided cases of diabetes and CHD were of 23.4 and 3.7 per 1000 treated patients with aripiprazole compared with SOC. If patients were treated with aripiprazole as the first agent, the accumulated direct avoided costs over a 10 year period for diabetes would be of US$10 millions and for CHD would be of US$17 million. This represents total accumulated savings for the Mexican Health Care system of US$27 millions during this period. CONCLUSIONS: Usage of aripiprazole in the Mexican Health Care system can be translated into a significant reduction of health care costs due to the favorable metabolic profile of this drug when compared to SOC.