BACKGROUND: The value of a drug can be expressed as the needed cost to increase a health unit. An estimation of an index that summarize the value of a molecule with multi-indication, however, is a complex process. OBJECTIVES: Covet study had the specific objective of a comprehensive economic evaluation of adalimumab. METHODS: An Econometric algorithm has been developed to estimate the total economic value of Adalimumab. This value was calculated as the sum of the cost per QALY gained in the treatment of rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn's disease and psoriasis. The sum was weighted by prevalence data for each of the diseases considered. Boston Matrix has been developed to establish the relationship between demand (prevalence of the disease) and health supply (e.g. the willingness to pay - WTP - of the health care authorities). Finally, a League Table has been built in order to compare the cost-effectiveness of Adalimumab with other innovative molecules. A sensitivity analysis based on the variability of Economic Evaluation model of Adalimumab has been performed. RESULTS: The total economic value of Adalimumab in Italy amounted to €27,700. The sensitivity analysis showed a cost per QALY gained ranging between €19,487 and €32,453. The analysis of the Boston matrix, developed for each pathology, indicates that the cost per QALY gained of Adalimumab was generally below the common WTP with the exception of psoriasis (€52,600).  CONCLUSIONS: The study provides a first indication of the total economic value of Adalimumab, that is below the threshold value for health care interventions for all the main pathologies treated with this molecule. Results of the study are helpful for decision makers, who should ensure that patients have equal access to a cost-effective treatment, as well as promote research and development of innovative molecules with greater cost-effectiveness ratio.