OBJECTIVES: The next generation of artificial vision devices (AVDs), which is currently tested in clinical trials, has the potential to improve the vision of blind patients with retinitis pigmentosa (RP) in a manner that they will be categorized as visual impaired but no longer as blind. This unprecedented vision improvement will result in a mentionable quality of life gain which poses the question at which costs the next generation AVDs are to be regarded as cost-effective.  METHODS: In order to answer this research question a Markov model, with the health states blind, visual impaired and death, was developed to simulate and to compare the costs and effects of next generation AVDs versus best supportive care (BSC) over a lifetime horizon. Healthcare costs and health utilities for the Markov health states were determined on the basis of published literature.  For next generation AVDs, which are currently tested in clinical trials, various possible effect and pricing scenarios have been simulated. RESULTS: Applying the base case settings resulted in incremental costs of €107,925, in 2.03 incremental quality-adjusted life years (QALYs) and in a cost-effectiveness ratio of €53,165 per QALY gained. Probabilistic and deterministic sensitivity analyses as well as scenario analyses for the effect size and the AVD costs were performed in order to investigate the robustness of results. In these analyses a strong variation of the cost-effectiveness results was obtained ranging from €23,512 (best case) to €176,958 (worst case) per QALY gained. CONCLUSIONS: The innovative nature, the high unmet medical need and the expected unprecedented efficacy of next generation AVDs will highly likely lead to the case that even relatively high incremental cost effectiveness ratios, that have been obtained when simulating various effect and pricing scenarios, will be regarded as acceptable from a German healthcare payer perspective.