OBJECTIVES To estimate the cost-effectiveness of intrathecal baclofen therapy (ITB) against conventional medical management (CMM) in non-focal disabling spasticity (N-FDS) patients who are resistant or intolerant to oral therapy. METHODS A markov model was developed to estimate clinical and economic outcomes for patients treated with ITB or CMM. Treatment effects, patients´ baseline characteristics, resource utilization and health utility values were taken from the EPICE study. The model was built in accordance with the Institut Guttmann´s clinical practice, a reference center in Spain. Unit costs were obtained from the cited center. The analysis was conducted from the Institut Guttmann´s perspective over a lifetime horizon with direct medical costs (2013) and outcomes discounted at 3%. Uncertainty was assessed through univariate and multivariate sensitivity analysis (SA). RESULTS When comparing ITB with CMM, the model estimates ITB would increase remaining lifetime costs by €35,605 and result in a QALY gain of 1.06; thus showing an incremental cost-effectiveness ratio (ICER) of €33,619 per QALY gained. SA reflecting the most current clinical practice at the Institut Guttmann (where now a new catheter, associated with an 80% reduction in adverse events, is used) showed an ICER of €27,805 per QALY gained. ICER results were also sensitive to changes in the post-operation hospitalization period, baclofen dose titration management, pump battery life, and health utility values. CONCLUSIONS The present evaluation results in an ICER of ITB against CMM, in the treatment of N-FDS patients who are resistant or intolerant to oral therapy at the Institut Guttmann, close to a willingness-to-pay threshold of €30,000 per QALY gained. However, SA results indicate that the ICER drops below this threshold when most current clinical practice at the cited center is considered. Moreover, SA results suggest potential ways to optimize the current clinical pathway in order to reduce procedure costs even further.