OBJECTIVES Mitral Regurgitation (MR) is a cardiac disease resulting in backflow of blood from the left ventricle to the left atrium which could increase the risk of heart failure and mortality. Half of severe MR patients are not considered eligible to surgery (valve repair or replacement) and receive a medical treatment. MR patient management could benefit from usage of Mitraclip, a transcatheter device, which enables percutaneous edge-to-edge repair to treat MR. The cost-effectiveness model presented here compares Mitraclip therapy versus medical standard care treatment. METHODS A four-state Markov model (Death, MR grade 0, MR grade I /II, MR grade III/ IV) has been developed. In each state patients could be hospitalized or not. A national payer’s perspective was chosen with a 5 year time horizon. Primary and secondary endpoints were respectively the number of deaths and of hospitalizations avoided. Data were obtained from the EVEREST II high-risk study and from french cost analysis. RESULTS Within the time horizon analyzed, 276 further deaths could be avoided by using Mitraclip strategy out of 1000 patients with MR, compared to medical treatment. The Incremental Cost Effectiveness Ratio (ICER) is estimated at €93,000 per death averted with cumulative cost on five years. Sensitivity analysis shows that the cost of the initial surgery and the cost of the device where the two most sensitive variables. Costs of managing MR are higher for the Mitraclip option during the first year (€29,894 for Mitraclip compared to €8,557 for medical treatment) option due to the cost of the device and surgery, whereas this is inversed from the second year onwards (€8,557 for the medical option vs. €3,122 for Mitraclip). Therefore, an average ICER (20 720€ per death averted) has also been calculated. CONCLUSIONS Mitraclip might represent a new economically attractive treatment option for MR patients at high-risk which increases survival.