OBJECTIVES:  To assess the cost-effectiveness and cost-utility of AAS 100mg, simvastatin 40mg and ramipril 5-10mg (polypill), in comparison with its mono-components separately for secondary prevention of cardiovascular events with or without a recent history of MI, from the Mexican Health System perspective METHODS:  A cost-effectiveness and cost-utility analysis were developed through an economic Markov model, to evaluate the polypill in comparison with its mono-components separately. Effectiveness outcomes were expressed as life year’s gained and quality-adjusted life-years (QALY’s) associated with the benefits in adherence of the polypill. The study was conducted over a 20 years horizon, with a 5% discount rate. Costs were obtained from institutional sources. The direct medical costs considered were: pharmacological costs, acute adverse events and hospitalizations. Univariate and probabilistic sensitivity analyses were performed. The results were expressed as cost per life years gained and QALY’s, also incremental cost-effectiveness ratio (ICER) was calculated RESULTS:  The polypill presents 5.76175 life years gained and 4.78911 QALY’s, in comparison the life years gained with mono-components separately were 5.74624 and 4.77445 QALY’s. The polypill has a greater effectiveness compared with its mono-components with an incremental of 0.01551 life years gained and 0.01466 QALY’s. The average total cost per patient was €11,263.55 using polypill and €11,136.43 for mono-components, with an incremental cost of €126.98. The ICER estimated was €8,187.95 per life years gained and €8,662.68 per QALY’s. CONCLUSIONS:  Therefore, the polypill is a cost-effective option compared with its mono-components in the secondary prevention of cardiovascular events in adult patients with or without a recent history of MI in Mexico