OBJECTIVES: To determine the cost-effectiveness of bendamustine-rituximab (Ben-R) versus fludarabine-rituximab (Fdb-R) in patients with iNHL who have progressed following treatment with rituximab or a rituximab-containing regimen in Mexico.  METHODS: An economic model was constructed from the Mexican public payer perspective, with a 35-year (lifetime) horizon and a discount rate of 5%.  The model included three health states, progression-free (PF), progressive disease (PD), and death, which were associated with utility weights of 0.81, 0.62 and 0, respectively. Clinical inputs (response rates, Kaplan-Meier curves, hazard ratios (HRs) and adverse event rates) were from the Stil NHL 2-2003 study. Resource use data were from interviews with Mexican hematologists treating iNHL patients. Unit costs were obtained from Mexican Social Security Institute (IMSS) and were expressed as 2013 Mexican Pesos. Univariate and probabilistic sensitivity analyses were conducted to determine the key drivers of cost-effectiveness, and uncertainty around the results, respectively.  RESULTS: Total cost of Ben-R was $1,726,828 and total cost of Fdb-R was $1,640,024.  Ben-R patients accrued more LYs (5.82 vs. 4.73), QALYs (4.22 vs. 3.29), and PF LYs (3.37 vs. 1.96) compared to Fdb-R patients.  The ICERs were $79,890 (cost per LY), $92,788 (cost per QALY) and $61,486 (cost per PF LY). Univariate sensitivity analysis revealed that the ICER per LY was most sensitive to the PF survival (PFS) and overall survival (OS) HRs for Ben-R vs Fdb-R and the use of bone marrow transplants in the PD state. Probabilistic sensitivity analysis with 1,000 iterations estimated that Ben-R will be cost effective over 90% of the time at a willingness-to-pay threshold of $125,085. CONCLUSIONS: At a willingness-to-pay of $125,085 (GDP per capita of Mexico) Ben-R is cost effective versus Fdb-R.