OBJECTIVES Central retinal vein occlusion (CRVO) is caused by a blood clot in the central retinal vein, which slows or stops blood from leaving the retina. As a result, blood and fluids can accumulate, causing retinal injury and vision loss. Thus, a major complication in eyes with CRVO is macular oedema (ME) and is the primary factor for poor visual acuity and visual fields in non-ischemic CRVO. A global cost-effectiveness model was developed and adopted to estimate effects and associated costs, in Sweden, for treatment of ME secondary to CRVO with aflibercept compared to ranibizumab. METHODS A Markov model was developed, including health states that reflect the clinical treatment and disease progression/regression of the ME. The simulated patient population consisted of adults treated for ME secondary to CRVO with an average starting-age of 64 years. Patients were treated and monitored for two years and followed for 15 years in the base case. Treatment regimens were taken from clinical trials with aflibercept (GALILEO & COPERNICUS) and ranibizumab (CRUISE & HORIZON), with 8.2 vs. 8.8 injections the first year and 2.9 vs. 3.5 injections the second year, respectively. RESULTS Aflibercept can be regarded as a cost-effective, i.e. dominating, treatment-alternative compared to ranibizumab as aflibercept is both less costly (total incremental cost of more than -35,000 SEK) and more effective (total incremental QALYs of 0.061) than ranibizumab. Due to the more treatments, ranibizumab had higher drug (incremental cost: -8,537 SEK) and administration (incremental cost: -5,793 SEK) costs compared to aflibercept. Probabilistic sensitivity analysis showed that aflibercept was dominating over ranibizumab in 70% of the simulations. CONCLUSIONS Aflibercept is more cost-effective than ranibizumab for the treatment of ME secondary to CRVO in Sweden.