OBJECTIVES: To compare the costs and effectiveness of dabigatran etexilate with current standard treatment in patients with non-valvular atrial fibrillation (NVAF), from the Slovakian health care system perspective.  METHODS: A  previously published Markov cohort model was adopted to estimate the outcomes of patients with dabigatran (150mg BID, 110mg BID) in its labelled indication during their lifetime for the following health states: ischemic and haemorrhagic stroke, transient ischemic attack, systemic embolism, intracranial and extracranial haemorrhage, acute myocardial infarction, minor bleeds and death. Data on event rates and patient quality of life associated with different health states and patient survival time was based on the RE-LY trial and the literature. The base-case consisted of a cohort of patients with NVAF,  CHADS2≥1 and no contraindications to anticoagulation therapy. The modelled consequences of the clinical events were costs, disability and/or reduction in quality of life and death. Data on resource use associated with patient management and different events were estimated using a Slovakian expert panel, while unit prices were collected from the official sources update 2011. One-way sensitivity analyses was used on all relevant variables to test the robustness of the analysis. RESULTS: The dabigatran group had more life years and QALYs gained compared to standard treatment (warfarin, aspirin, clopidogrel and no treatment); these gains were primarily driven by a lower incidence of the intracranial events and systemic embolism.  A cohort of 5,000 patients treated with dabigatran during their lifetime gained 40,238 QALYs (standard: 38,178 QALYs) with incremental costs of €35.9mill (standard: €37.3 mill). The incremental cost-effectiveness ratio (ICER) of dabigatran versus standard treatment was estimated at €17,437, below the Slovakian acceptable threshold (€18,000 per QALY gained). The sensitivity analysis consistently demonstrated the cost-effectiveness of dabigatran. CONCLUSIONS: Dabigatran represents a cost-effective treatment for preventing strokes in patients with NVAF in Slovakia.