OBJECTIVES: To estimate the cost-effectiveness of three candins (anidulafungin, caspofungin, and micafungin) and generic fluconazole in the treatment of non-neutropenic adult patients with candidemia and/or invasive candidiasis (IC) in intensive care units (ICU) in Spain. METHODS: A decision tree model was performed. The success (clinical and microbiological response) and safety (hepatic and renal adverse effects) of first-line treatments were obtained from meta-analyses and systematic reviews of clinical trials. In the case of failure, a second-line treatment (liposomal amphotericin B after the candins, or one of the candins after fluconazole) was administered. The duration of the treatments (14 days total) was established by IDSA guidelines. The cost of the medications and renal toxicity were considered. Deterministic and probabilistic sensitivity analysis using Monte Carlo simulations were carried out. RESULTS: The total cost of the treatment of candidemia and/or invasive candidiasis with anidulafungin, caspofungin, micafungin, and fluconazole was € 5483, € 5968, € 6231, and € 2088, respectively. Anidulafungin was the dominant treatment (more effective, less expensive) compared to micafungin and caspofungin. The cost of achieving one more patient successfully treated with anidulafungin, caspofungin, and micafungin compared to fluconazole was € 17,199, € 23,962, and € 27,339, respectively. The result remained stable despite modification of the duration of the first-line and second-line treatments, as well as most of the dosing regimens. The probabilistic analysis also remained stable. CONCLUSIONS: According to the model, anidulafungin produced savings and was the dominant treatment compared with micafungin and caspofungin in non-neutropenic adult patients with candidemia and/or invasive candidiasis in ICUs in Spain.