OBJECTIVES: To evaluate economics of nilotinib 600 mg and dasatinib 100 mg, compared to imatinib 400 mg, as first line therapy in chronic myeloid leukemia in Colombia, from third payer perspective. METHODS: A markov model used to evaluate 100 patients, aged 55 years, with newly diagnosed CML in chronic phase, in a 10 year time horizon. Progression free life years saved (PF-LYS) were considered the analysis outcome. Transition probabilities were analyzed in the model according to literature review. A 3% discount rate was applied to costs and outcomes. In the absence of any head to head trials to compare nilotinib and dasatinib, comparisons were made independently for each one versus imatinib. Costs analysis included direct medical costs obtained from local health care providers databases at prices for year 2011. Transplantation costs were excluded. Prices for medicines were estimated from official government top reimbursement prices. There was a univariate and multivariate Montecarlo sensibility analysis. RESULTS: Nilotinib was greater expected PF-LYS (15,376 vs. 14,643 for Imatinib), followed by Dasatinib (15,108 vs. 14,789 for Imatinib). Imatinib had lower total lifetime costs. The incremental cost-effectiveness ratio (ICER) was USD $6.828 per PF-LYS in the Nilotinib arm and USD $32.501 per PF-LYS for Dasatinib arm, each compared to Imatinib. When analyzing indirectly Nilotinib vs. Dasatinib, Nilotinib was found to be dominant due to higher efficacy (267,65 PF-LYS) and less costs (USD $5.290) in the base case. The multivariate sensitivity analysis showed that Nilotinib maintained its dominance against Imatinib and Dasatinib in most scenarios. The average estimated cost to manage disease progression per three months was USD $ 17.335 which was considered as threshold. CONCLUSIONS: From a third party payer perspective in Colombia, using PF-LYS, nilotinib is highly cost-effective when compared to imatinib and dominant vs dasatinib in first line therapy for CML in chronic phase.