OBJECTIVES: The objective of this analysis was to evaluate the cost-effectiveness of bimatoprost 0.03%/timolol 0.05% (BTFC) preservative-free (PF) fixed combination compared with dorzolamide/timolol PF fixed combination (DTFC PF), and tafluprost PF/timolol PF unfixed-combination (TTUF PF) for the treatment of primary open-angle glaucoma (POAG). METHODS: A cost-effectiveness and cost-utility model was developed to estimate lifetime costs and outcomes. The analysis was performed from a UK NHS perspective. No head-to-head evidence was available for BTFC PF and the comparators; therefore effectiveness estimates in terms of the mean lowering of intraocular pressure (IOP) at Week 12 were estimated using a mixed treatment comparison (MTC). Estimates of visual field progression were taken from the literature and modelled by an irreversible decrease in patients’ mean deviation (MD) score in each 12-week cycle. Resource use levels for each of the health states were obtained using a clinician survey. All costs and utilities were obtained from literature or NHS cost sources. Outcomes were reported in terms of cost per mmHg IOP gained and cost per quality-adjusted-life-year (QALY). Deterministic and probabilistic sensitivity analyses were performed. RESULTS: The cost-effectiveness results indicated that BTFC PF dominates DTFC PF and TTUF PF, with patients treated with BTFC PF having a greater IOP reduction (1.6 mmHg) and incurring lower lifetime costs (£2,294 vs. DTFC PF, £2,919 vs. TTUF PF). The cost-utility results indicate BTFC PF dominates DTFC PF and TTUF as well with an incremental gain of 0.03 QALYs.  Deterministic sensitivity analyses indicate the results are most sensitive to the rate of visual field progression.  Probabilistic sensitivity analysis indicates that BTFC PF has a 98.8% probability of being cost-effective at a threshold of £20,000/QALY. CONCLUSIONS: BTFC PF is considered a cost-effective treatment option for the treatment of POAG when compared with DTFC PF and TTUF PF from a UK NHS perspective.