OBJECTIVES: The use of multimodal analgesic management has been implemented for minimizing adverse events and to improve the patient recovery process which will have a significant impact on clinical and economic outcomes. The aim of this study was to develop an economic assessment of parecoxib, ketorolac and morphine for the treatment of postoperative pain (POP) for patients after total abdominal hysterectomy at the Social Security Mexican Institute (IMSS) from an institutional perspective. METHODS: A Bayesian decision-tree model was developed to simulate costs and health outcomes over a 6-day time period in patients treated with multimodal analgesic. Comparators assessed were: morphine (61.5 mg/day) plus parecoxib (40 mg/day); morphine (61.5 mg/day) plus ketorolac (90 mg/day) and morphine (61.5mg/day) alone. The effectiveness measure was: percentage of successful response without adverse events(AE) meeting the highest possible score for patient’s global evaluation survey (excellent). This survey has been previously validated in Mexico. Costs and resource use were collected from hospital records related to patients undergoing total abdominal hysterectomy at IMSS in 2008 (n=98). Transition probabilities were collected from international published literature and model was calibrated according to international pharmacoeconomics guidelines. One way and probabilistic sensitivity analyses were performed by Monte Carlo Simulation second-order approach.  RESULTS: Percentage of successful response without AE resulted for parecoxib in 35%, followed by ketorolac with 24% and morphine with 21%. Estimated cost per patient treated were lower for ketorolac (US$ 5,309.20) followed by morphine (US$5,343.96) and parecoxib (US$5,375.78). No meaningful statistical differences were found in costs among competing alternatives (p>0.05). ICER for additional successful response was US$ 601.29 for parecoxib against keterolac. Acceptability curves showed that parecoxib is the most cost-effective therapy with 90% at a willingness to pay of US$4,500.  CONCLUSIONS: Parecoxib represents a cost-effective analgesic alternative for POP management in patients who underwent abdominal hysterectomy at the IMSS.