OBJECTIVES: Invasive Aspergillosis (IA), a second cause of fungal invasive infections, is acquired by inhalation of spores.  The primary infection is developed in lungs and it migrates to other structures.  Mortality rate is 50% reaching up to 95% in bone marrow transplants.  The aim of this study was to assess the cost-effectiveness (CE) of voriconazole, amphotericine B and caspofungin as first-line treatments for IA inmunosupressed adult patients in Dominican Republic, from the private health care’s perspective. METHODS: A cohort of patients with IA study was conducted using a decision-tree model to compare costs and effectiveness of of amphotericin B IV (15mg/kg/day) (basecase), caspofungin IV (initial dosage 70mg/day, maintenance dosage 50mg/day), and voriconazole IV (12mg/kg/day). Effectiveness measures were: clinical success rates, mortality rates, intensive care unit (ICU) length of stay (LOS) and hospital ward LOS. The model used a 12-week time horizon and only direct medical costs were considered. The epidemiologic data was collected from published literature. Local cost data (expressed in 2011 US$) was retrieved from Dominican Republic´s private hospital official databases.  Monte Carlo probabilistic sensitivity analysis (PSA) was constructed.  RESULTS:  Results showed voriconazole as the least expensive and most effective option for IA patients.  ICU LOS was 7.59, 9.81, and 9.94 days for voriconazole, amphotericine B, and caspofungin, respectively.  Hospital LOS was 15.4 days with voriconazole, 16.4 days with caspofungin and 16.5 with amphotericine B. Voriconazole obtained the lowest mortality rate (34.1%) in comparison to  amphotericine B (50.9%) and caspofungin (44.7%). Furthermore, in regards to overall expected costs voriconazole resulted US$2711.25 and US$6881.05 less expensive than amphotericine B and caspofungin, respectively.  CE analyses showed voriconazole as the cost-saving strategy.  PSA results support these findings.   CONCLUSIONS:  In the private context of Dominican Republic, voriconazole resulted as a cost-saving option for treating IA inmunosupressed adult patients.