OBJECTIVES: To demonstrate the cost-effectiveness (CE) of ticagrelor in the treatment of Acute Coronary Syndrome (ACS) in specific population: invasive and non-invasive treatment, Unstable Angina (UA), ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and with or without diabetes. METHODS: Analysis of ticagrelor+acetylsalicylic acid (ASA) and clopidogrel/ASA as fixed dose combination (FDC) was made using results of PLATO study and its sub-studies. A Markov model was developed to evaluate each specific population at a time horizon of 14 years from an institutional perspective in Mexico. Life years gained (LY) was the outcome measure. An incremental cost-effectiveness ratio (ICER) was performed. Direct health care costs were used and a 5% discount rate was applied. A Sensitivity Analysis (SA) and Cost Effectiveness Acceptability Curve (CEAC) were performed. RESULTS: The ICERs of Ticagrelor+ASA vs. clopidogrel/ASA for each specific population were: $4,647 for UA; $4,024 for Non-STEMI; $4,128 for STEMI; $4,607 for Invasive-treatment and $4,672 for population without Diabetes. The best results are shown in the Non-Invasive-treatment and Diabetes groups with ICERs of $3,275 and $3,011, respectively. The results of SA were consistent with the base case. The likelihood of Ticagrelor+ASA to be cost-effective is 100% under the willingness-to-pay threshold in Mexico of one PIB per-capita ($10,064). CONCLUSIONS: Ticagrelor+ASA was CE compared with clopidogrel/ASA in all specific groups, especially in diabetes, non-invasive and NSTEMI patients. Therefore it could be considered as the first option for treating these patients in an institutional setting.