OBJECTIVES:  Compare the cost per cure of telaprevir of peginterferon and ribavirin (TVR+PR) compared to boceprevir plus peginterferon  and ribavirin (BOC+PR) in the treatment of METAVIR scale F2 patients with previously untreated chronic hepatitis C genotype 1 in the Brazilian public (SUS) and private (SS) healthcare system. METHODS: Treatment costs considered drug acquisition costs of TVR+PR and BOC+PR from a public and private payer perspective in Brazil. The cost/cure was defined as the cost/sustained virological response (SVR) according to the phase 3 trials of TVR and BOC. The SVR rate for TVR+PR was defined as 79% and 49% for PR in patients with F2 fibrosis. Based on the SPRINT-2 trial, the SVR-rate for F2 patients treated with  BOC+PR was assumed 57%, average between F0/F1 and F3/F4 patients, compared to 38% for PR. Treatment duration, based on the extended rapid virological response (eRVR), was taken from the respective trials of BOC (eRVR = 44%) and TVR (eRVR = 58%). Deterministic sensitivity analysis was carried out for the eRVR rate. RESULTS:  In the SUS, TVR+PR had an average treatment cost of R$ 40.093 per F2 fibrosis patient compared to R$ 36.185 with BOC+PR. Considering the SVR rate and the sensitivity analysis, TVR+PR had a cost/SVR of R$ 50.751 (R$ 49.797-R$ 51.705) compared to R$ 63.481 (R$ 61.771-R$ 65.191) with BOC+PR.  In the private healthcare system, TVR+PR had a treatment cost of R$ R$ 88.508 per F2 fibrosis patient compared to R$ 82.518 with BOC+PR. Considering the cost/SVR and sensitivity analysis, TVR+PR had a cost/SVR of R$ 112.036 (R$ 108.253-R$ 115.819) compared to BOC+PR with a cost/SVR of R$ 144.768 (R$ 140.631-R$ 148.905) per F2 patient in the SS. CONCLUSIONS:   Compared to BOC+PR, TVR+PR was a more cost-effective treatment of F2 fibrosis patients in both public and private healthcare systems.