OBJECTIVES: The standard of care for patients with atrial fibrillation (AF) is warfarin. However, warfarin use is limited by a narrow therapeutic range and documented risk of bleeding. This study aims to compare expected costs and clinical consequences of the usage of apixaban versus warfarin in the Mexican population AF setting.   METHODS: A hypothetical patient cohort of 7,348 was evaluated, estimated from AF prevalence in 1,000,000 Mexicans. A decision tree model was developed considering annual costs and annual clinical consequences for both treatments. Effectiveness measures included the number of events for (1) stroke/systemic embolism, (2) bleeding and (3) mortality. Event costs were estimated for each group. Under a conservative scenario, mortality events and INR monitoring were not considered. Rates for stroke, mortality and bleeding were extracted from the ARISTOTLE trial. Costs were estimated from a public health care perspective. Costs of treatment of events related to stroke and major bleeding corresponds to Diagnostic Related Groups published by IMSS. All costs are expressed in 2013 USD ($1USD=$13MXN). Sensitivity analysis was performed. RESULTS: Total number of events was lower for the apixaban cohort, the yearly stroke/systemic embolism events relative risk reduction was 21% versus the warfarin cohort (93 vs. 118 events, respectively), while the relative risk reduction of bleeding events was 31% (157 vs. 227). Apixaban had an 11% relative risk reduction vs. warfarin in all cause mortality, with warfarin having 31 more mortality events for this cohort. The total cost of events for warfarin group was $600,849 for stroke/systemic embolism events and $742,011 for bleeding events while for apixaban group it was $476,924 and $511,483, respectively. Total costs of events were 26% higher for warfarin group ($1,342,860 vs. $988,407). CONCLUSIONS: The better clinical profile of apixaban when compared with warfarin has also important financial implications in terms of lower treatment costs for the events considered.