OBJECTIVES: To perform a cost-effectiveness analysis of Fingolimod 0.5mg for Relapsing-Remitting Multiple Sclerosis versus first line treatment options available in the Public Health Care System in México. METHODS: A Markov model was designed to analyze the cost-effectiveness of Fingolimod vs Glatiramer Acetate and Interferon-β (IFNβ). The model identifies 5 health-states based on the Expanded Disability Status Scale. A systematic review was performed to obtain transition probabilities used in the model. Clinical data for Fingolimod comes from two main studies, FREEDOMS and TRANSFORMS, with around 2,186 patients analyzed. Fingolimod showed a reduction annualized relapsed rate with fingolimod was significantly lower (0.18 and 0.20) versus its comparators with placebo and interferones (0.40 and 0.33).   Cycle duration was 1 month, and time horizon 10 years with a discount rate of 5%. Efficacy was evaluated by QALYs using utility data from international literature. Direct medical costs include the number of relapses expected in each of the treatments. Relapses cost are valuated according to the event severity identified in the DRGs List published by the Mexican Institute of Social Security. Drug costs are those from public tenders 2011. (US$1=MX$13.8).  Probabilistic sensitivity analysis (PSA) was performed using Monte Carlo technique. RESULTS: The expected 10–year costs and QALYs per patient with each treatment were: Fingolimod US$337,994/5.62; IFNβ-1a6MU US$428,689/1.64; IFNβ-1a12MU US$468,958/1.59; IFNβ-1b8MU US$493,690/1.49; Glatiramer Acetate US$526,444/ 1.65. PSA showed Fingolimod was dominant or below the Mexican threshold of 1 PIB per cápita (= US$8,586) vs all comparators, 85% of the times. Robustness in the results were confirmed though the sensitivity analysis. CONCLUSIONS: For patients with Relapsing-Remitting Multiple Sclerosis, treatment with oral Fingolimod is an efficacious and cost-saving option compared with current available options in the health system. The higher drug acquisition cost of Fingolimod is compensated by its lower rate of relapse and disability progression.