OBJECTIVES : To perform a cost-effectiveness analysis of Indacaterol/ Glycopyrronium (IG) against tiotropium monotherapy (TM), salmeterol/fluticasone (SF) and indacaterol/tiotropium (IT) for COPD patients from the perspective of the Mexican Public Healthcare System.   METHODS: A patient-simulation model structured in MS Excel, developed and validated by Asukai et al (2013), allowed us to compare IG against tiotropium monotherapy (TM), salmeterol/fluticasone (SF) and indacaterol/tiotropium (IT). The effectiveness measures analyzed were life years gained and exacerbations avoided based on efficacy data extracted from a comprehensive large phase III trial program comprising 11 studies (ILLUMINATE, SHINE, BRIGHT, ENLIGHTEN, SPARK, BLAZE, ARISE, BEACON, RADIATE, LANTERN, FLAME) with more than 10,000 patients across 52 countries. COPD drug cost, maintenance cost and exacerbation cost were estimated for six months duration of model cycle, using local prices for public healthcare institutions and evaluating the resources utilization data extracted from a sample of medical records. Lifetime horizon was used and a discount rate of 5%. Deterministic and probabilistic sensitivity analysis was performed. RESULTS: Total expected costs per patient were US$30,421 and US$31,577 for the comparison IG vs TM respectively; US$28,817 and US$28,852 for IG vs SF respectively; US$28,900 and US$34,557 for IG vs IT respectively.  IG delivers slightly more life years than comparators, but avoid significantly more exacerbations than the other options (1 to 4) which in turn have favorable economic impacts. Sensitivity analysis showed that base-case results are robust to variations of key model parameters  CONCLUSIONS: Indacaterol/ Glycopyrronium resulted more effective and less costly than comparators. These results showed that is possible to achieve cost-savings and a potential clinical benefit with the fixed dose of IG for Mexican patients with COPD.