Chronic myeloid leukemia (CML) is a relatively rare disease having an annual incidence of approximately 1 – 2 per 100 000 people, and accounts for 15 – 20% of adult leukemias. The main objective of this study is to compare costs and outcomes associated with the use of nilotinib 300 mg versus imatinib 400mg in patients with newly diagnosed chronic myeloid leukemia from the health insurance prespective METHODS: A decision tree model over 36 months was constructed to compare the outcomes and costs of nilotinib versus imatinib in patients with newly diagnosed CML theThe probability of patients achieving major molecular response (MMR) was the main clinical outcome used in this study and was derived from ENESTnd trial. Utilities data were derived from previously published study using the time trade off method. Direct medical costs were collected from the health insurance hospitals Deterministic sensitivity analysis was performed. RESULTS: Two scenarios were adopted in the model; per-protocol analysis and intent –to treat (ITT) analysis. For per-protocol analysis, nilotinib 300 mg is cost effective compared with imatinib 400mg at an ICER of 76793 EGP/QALY. For intent-to treat analysis, nilotinib 300 mg is less costly and more effective than imatinib 400 mg. Deterministic sensitivity analysis in per-protocol analysis showed that probability of patients still on core treatment of nilotinib has the largest impact on the results while in ITT analysis, the probability of no MMR response has the largest impact on the results. CONCLUSIONS: Nilotinib 300 mg is a good value for money compared to imatinib 400 mg in patients with newly diagnosed CML from the health insurance perspective.