OBJECTIVES: Assessing the benefit of enoxaparine on healthcare budget for the prophylaxis of the venous thromboembolism disease (VTE) and the treatment of deep vein thrombosis (DVT) with and without pulmonary embolism (EP) in Spain and its Autonomous Communities (ACs).  METHODS: Prophylaxis patients were classified as moderate or high-risk according to the surgery type. The budget impact was estimated by comparing the cost in a scenario where 100% of the market is covered with enoxaparine from a scenario with only bemiparine. An additional analysis was performed considering the current treatment setting with all heparins available in the market versus a projected scenario where all patients receive enoxaparine. Cost estimation was based on real sales per product and pack over a year (March 2014 to February 2015) obtained from IMS Health database (Dataview), and on the retail price plus the value-added tax in 2015, discounting the deductions according to Royal Decrees.  RESULTS: In the scenario comparing enoxaparine to bemiparine, the administration of enoxaparine for VTE prophylaxis would lead to a cost saving for the national health system of 10.138.123€ for high-risk patients and 744.684€ for moderate risk patients, depending on the AC savings range from 22.524€ to 1.952.898€ and from 2.314€ to 162.328€ in patients with high and moderate risk, respectively. In the treatment of DVT at national level the average savings come to 8.125.273€, and at regional level these vary between 21.969€ and 1.671.395€.  Savings obtained when comparing a scenario with only enoxaparine versus the current setting with all heparins come to 3.368.555€ and 9.813.120€ for prophylaxis of VTE and treatment of DVT, respectively, at national level.   CONCLUSIONS: Broader use of enoxaparine for the prophylaxis of VTE and treatment of DVT with and without PE in Spain and its ACs would lead to an economic benefit for the Spanish health system.