OBJECTIVES: To estimate the costs associated with the use of dabigatran (DB) vs. dicoumarins (DC) in non-valvular atrial fibrillation (NVAF) from the perspective of the Extremadura Public Health System (EPHS) in 2013. METHODS A budget impact study of anticoagulant therapy (AT) with DB and DC in patients with NVAF was carried out during 2013. The data were processed using the JARA® electronic record application. Pharmaceutical costs and costs associated with patient follow-up and monitoring were included. Costs relating to incidence of stroke, gastrointestinal bleeding, intracranial haemorrhage and acute myocardial infarction were also included based on RE-LY clinical trials. For pharmaceutical cost RRP + VAT of the medicinal products was used, and other health care costs were based on the public prices of the EPHS and the National Health System. RESULTS Three hundred eighty-five patients were treated with DB (4.01 %) and 8876 with DC (92.63%). Mean age was 77 (95 % CI:  76.82-77.19). Total expenditure for AT with AVK for the best case scenario would be €3,036,604.28 (mean cost per patient: €342.11; 95% CI:  341.80-342.34) and the worst case €3,727,169.83 (€419.92; 95% CI: 419.70-419.15) and for DB €318,077.15 (mean expenditure: €826.27; 95% CI: 796.81-855.57). For a DB market penetration of 50%, expenditure on anticoagulation of these patients would be €3,958,659.57 while for 75% it would be €5,937,989.36. CONCLUSIONS Dabigatran is a more costly option than classic treatment with DC. In 2013 this drug's market penetration was limited and was closer to other estimates. Estimated mean cost per patient for DCs is similar to the estimates of other communities (Basque Country: €300-700 and the Valencian Community: €300) and are somewhat lower for DB (Basque Country: €1,197 and the Valencian Community: €1,350). A limitation of the study is that the safety data were obtained from clinical trials rather than actual clinical practice with these drugs.