OBJECTIVES: To estimate the incremental cost-effectiveness ratio (ICER) of dual-mobility cups (MBH) when used instead of conventional cups (FBH) to help reduce dislocation rates following total hip replacement (THR) in France. METHODS: A Markov model simulated two cohorts of patients: one with MBH and one with FBH. Three different states of health were considered: “stable”, “dislocation/revision” and “death”.  The model adopted a collective perspective and the time horizon of the model was lifetime. Dislocation/revision rates were estimated using two different sources: literature review and expert opinions (analysis 1) and analysis of the PMSI (French hospital database) of Patients having one THR in 2009 followed through the end of 2012 (analysis 2). Costs considered were hospitalization costs (reduction/revision for dislocation performed in acute care unit and care in rehabilitation units), valued using the National Scale Costs with Common methodology (ENCC). Outpatients’ costs were considered for patients going back home after hospitalization and valued by expert opinions and literature data. The model estimated the number of dislocations/revisions for each cohort and differences between the two groups in terms of QALY gained, costs and cost-effectiveness ratio. Deterministic and probabilistic sensitivity analyses (PSA) were conducted. RESULTS: In analysis 1 for a 100,000 THR cohort, 4,626 dislocations and 1,243 revisions were avoided. Total number of QALY gained was 894 and total economic gain €44.7 million. In analysis 2, 3,176 dislocations and 854 revisions were avoided for an economic gain of €30.7 million and a gain of 611 QALY. Reported to 100,000 THR, the economic gain per MBH cup was €447 or €307. PSA estimated the mean ICER to €-55,693 per QALY gained. CONCLUSIONS: Because of the current rules of tariffs used in France and given the absence of additional costs associated with the use of DM prosthesis, this strategy can be considered dominant in THR.