OBJECTIVES: Compare the cost-per-remission of adalimumab (ADA) to infliximab (IFX) for the treatment of moderately to severely active ulcerative colitis (UC) in the Brazilian public health care system (SUS). METHODS: Treatment costs considered drug acquisition costs from a public payer perspective in Brazil considering an average patient of 80 kg. The cost/vial of IFX and ADA were defined by the latest government acquisitions, as published in the official website comprasnet.gov.br. The time horizon was defined at 8, 52 and 54 weeks of treatment. The recommended dose and dosing intervals were according to label of each drug.  The nnt was calculated based on the clinical remission data gathered at week 8 and week 52/54 from the published phase III clinical trials of ADA and IFX, ULTRA-2 and ACT I respectively.  (Rutgeerts P 2005; Sandborn WJ 2012) RESULTS: At week 8, IFX has a treatment cost of R$ 13.652 with a cost-per-NNT for clinical remission of R$ 54.610 (bio-naive and all patients), compared to ADA with a treatment cost of R$ 8.284 and a cost-per-NNT for clinical remission of R$ 115.983/patient and R$ 82.845/bio-naive patient. At week 52/54, IFX has a treatment cost of R$ 36.406 compared to ADA with R$ 31.067/R$ R$ 32.102 per patient.  Considering the cost-per-NNT for clinical remission at week 52/54, ADA has an average cost of R$ 341.735 compared to IFX with a cost-per-NNT for clinical remission of R$ 182.032 at week 52/54. Considering bio-naive patients, IFX remains with a cost-per-NNT for clinical remission of R$ 182.032 compared to ADA with R$ 310.668/R$ 341.735 at week 52/54. CONCLUSIONS: IFX has a lower number needed to treat  and a lower cost-per-NNT to achieve clinical remission at both week 8 week 52/54 compared with ADA in the treatment of moderately to severely active ulcerative colitis, independently of patient subgroup.