OBJECTIVES: Venous thromboembolism (VTE) which comprises deep vein thrombosis (DVT) and pulmonary embolism (PE) is associated with a significant healthcare burden.  Currently, the standard of care is parenteral low molecular weight heparin (enoxaparin) plus warfarin. Rivaroxaban is an oral anticoagulant that does not require dose adjustment or routine coagulation monitoring, bringing an important advantage for the treatment of VTE. The EINSTEIN clinical program of rivaroxaban showed that, overall, hospitalized patients who received initial treatment with rivaroxaban for DVT and PE had a significantly shorter length of stay compared to patients who received enoxaparin/VKA. Therefore, the aim of this study was to compare the direct costs of treatment with rivaroxaban versus enoxaparin/warfarin. METHODS: A cost-minimization analysis (CMA) was chosen once the EINSTEN program showed that rivaroxaban is non-inferior to enoxaparin/VKA with regards to efficacy for treatment of VTE being possible to consider that there is no difference in outcomes. Perspective was from the Brazilian private healthcare system and time horizon was one year. Costs related to hospitalization, outpatient management and adverse events were obtained by micro-costing approach and resource use captured from literature and expert panel. Costs were expressed in 2015 prices and exchange rate used was $1.00USD=4.00BRL. RESULTS: Rivaroxaban use resulted less expensive than enoxaparin+warfarin in the treatment of VTE. Estimated total cost of treatment for one patient with VTE is $1,559 with rivaroxaban and $2,007 with enoxaparin+warfarin. The greater difference in costs was for treatment of PE, which was $481.05 less for rivaroxaban. For DVT treatment, estimated savings for rivaroxaban was $399.45. Robustness of the model was tested in a deterministic univariate sensitivity analysis in which all results remained cost saving. CONCLUSIONS: Rivaroxaban is a cost-saving alternative compared to the current practice for the treatment of VTE under the perspective of the Brazilian private healthcare system.