OBJECTIVES: Orthopedic surgery has been associated with significant risk of develop deep vein thrombosis (DVT). The objective of this study was to estimate the cost-effectiveness of thromboprophylaxis therapies for prevention of DVT associated in patients undergoing hip surgery from an institutional perspective (Mexican Social Security Institute, IMSS). METHODS: Economic and health consequences of thromboprophylaxis were assessed through a six-state Markov model (one-year time horizon, one-week cycles). Effectiveness measure was reduction in DVT (per 1000 patients). Effectiveness was estimated by local meta-analysis. Doses of alternatives compared were: warfarin (basecase, 5mg 30d); dalteparin (not listed in Mexican formulary, 5000 IU/day 30d); acenocoumarol (4 mg/day 30d); enoxaparin (40 mg/day 30d); nadroparin (5700 IU/day 30d) and  unfractionated heparin (UFH) plus warfarin (10000 IU/day 10d+warfarin 5 mg/day 20d). No prophylaxis was assessed too. Resource use and unit costs were extracted from IMSS databases (dalteparin cost was provided by the manufacturer). Costs included outpatient and inpatient services, medication costs, imaging and laboratory tests. Univariate sensitivity analysis was performed. Acceptability curves were constructed. RESULTS: DVT cases per alternative were: warfarin 61 (CI 95% 60–62); dalteparin 33 (32–34); acenocoumarol 80 (78–82); enoxaparin 57 (56–58); nadroparin 67 (66–68); no prophylaxis 212 (205–219) and UFH 229 (223–235). Per patient annual cost (2011 US$) were: warfarin $3071.34 ($3049.23- $3093.44); dalteparin $2,980.42 ($2958.14-$3002.71); acenocoumarol $2966.93 ($2940.92–$2992.94); enoxaparin $3668.54 ($3631.18–$3705.90); nadroparin $3291.15 ($3260.60–$3321.70); no prophylaxis $3466.68 ($3407.63–$3525.73) and UFH $3356.00 ($3311.59–$3400.41). Warfarin was dominated by dalteparin, Dalteparin is cost-saving, compared to enoxaparin, nadroparin, UFH and no prophylaxis. Regarding warfarin, ICER (per DVT case avoided) of enoxaparin and acenocoumarol resulted in $149.30 ($146.24-$152.36) and $5.49 ($5.38-5.61), respectively. Acceptability curves showed that results were robust. CONCLUSIONS: At IMSS, dalteparin would be a cost-saving or cost-effective therapy for thromboprophylaxis in patients undergoing hip surgery.