OBJECTIVES: Assess the budget impact of Sacubitril/Valsartan (LCZ696) versus Enalapril (ACEi) for the treatment of Heart Failure with reduce ejection fraction (HFrEF) from the perspective of the Chilean public healthcare system. METHODS: A cohort of patients with HFrEF was modeled using epidemiological data (prevalence, incidence, proportion with reduced ejection fraction and class NYHA II-IV) from international literature, in accordance with ISPOR principle good practice. Two scenerios were compared, one representing the current practice in Chile where all patients are treated with ACEi, and the other were all patients are treated with LCZ696. Expected costs were measured in Chilean pesos (1 USD = 654.07 CLP$). The analysis was performed from the perspective of Chilean public health assuming a 100% reimbursement. We considered pharmacological, adverse event, base treatment for HFrEF, hospitalization, drug titrate and follow up cost. Annual costs were estimated considering a time horizon of five years. RESULTS: The budget impact was presented for two possible prices of LCZ696. When considering current full monthly price of US$139 per month an additional of US$175,796,847 relative to ACEi is needed in the first year, and US$188,036,300 for the second year. A price reduction of 25% reduced the incremental cost to US$132,994,650 relative to ACEi in the first year, and US$138,434,069 in the second year. CONCLUSIONS: Despite for the highest cost for LCZ696, items like cost for hospitalization and adverse event were significantly favorable for innovator drug. For the range of the prices assessed, the impact of implementation of LCZ696 for the treatment of HFrEF on the Chilean health system’s budget varies from 1.60% and 1.69% on the first year and increase to 1.35% and 1,42% respectively from the second year.