OBJECTIVES: To evaluate the cost-effectiveness of rivaroxaban versus o enoxaparin+warfarin in the treatment of DVT.  METHODS: A Markov model simulating the progression of DVT in the course of three month cycles, up to death, was adapted to Turkish setting. The health states included the events related with recurrent DVT and bleeding. The model provides the comparison of six-month treatment with rivaroxaban against enoxaparin+warfarin. Event rates and the treatment effects of rivaroxaban were derived from EINSTEIN DVT clinical trial. Time horizons studied were 5 years and life-time. Utility values were based on the published literature. Local 2012 prices were used as source of the costs. The incremental cost-effectiveness ratios (ICER) were calculated with life-years (LYs) and quality-adjusted LYs (QALYs) gained. One-way sensitivity analyses were undertaken to examine the effects of model drivers. The analysis was undertaken from a payer perspective. Discount rate was set at 3.5% for both costs and outcomes. Mid-2012 USD currency rate was used. Willingness-to-pay (WTP) threshold was set as twice the local gross domestic product per capita (US$20,888).  RESULTS: The total cost of six-months treatment with rivaroxaban was US$89 and US$96* higher than warfarin. Increased drug cost (US$356) associated with rivaroxaban, was offset by reduced monitoring costs (US$239). Moreover, rivaroxaban was associated with LY increments of 0.006 and 0.026* years and QALY increments of 0.005 and 0.022* years. The ICERs were US$16,227 and US$3,488* per LY gained and US$17,928 and US$4,056* per QALY gained. Sensitivity analysis showed that ICER value was sensitive only to the frequency of monitoring (between two to six-times a year) in warfarin patients.  CONCLUSIONS: Rivaoxaban is cost-effective in the Turkish setting for the acute treatment of DVT patients, with ICERs below accepted WTP threshold across a range of conservative scenarios. * all pairs of figures correspond to 5-years and life-time horizon, respectively.