OBJECTIVES: To compare the cost-utility of Valsartan with the combination therapy Valsartan plus Hydrochlorothiazide used to treat adult patients with hypertension in the United States from the third-party payer’s perspective. METHODS: The study used the Medical Expenditure Panel Survey (MEPS) 2012-2014 database. The study population included individuals diagnosed with essential hypertension who were 18 years old and older. Patients using the combination therapy of Valsartan plus Hydrochlorothiazide were matched with those using only valsartan in 1:1 ratio using propensity scores. Study included all direct medical costs in MEPS which combined total healthcare expenditure, payments by private insurance, Medicaid, Medicare and other sources. Utility scores from Short Form 6D (SF-6D) were used to calculate quality-adjusted life years (QALYs). SF-6D scores were calculated from Physical and Mental Health Composite Scores (PCS & MCS) derived from SF-12 questionnaire. Monte Carlo probabilistic simulation technique was used to determine the cost-effectiveness acceptability curve. RESULTS: Total 794 adults with hypertension were included in the study, of which 498 individuals were taking only Valsartan and 296 were on the combination therapy of Valsartan plus Hydrochlorothiazide. After matching, there were 296 patients in each cohort. The total mean annual cost was found to be $12981.58 for Valsartan and $9551.97 for Valsartan plus Hydrochlorothiazide treatment. The mean utility gain for valsartan was found to be 0.7144, whereas for Valsartan plus Hydrochlorothiazide treatment it was 0.7233. Probabilistic sensitivity analysis showed that at all willingness-to-pay (WTP) thresholds, the probability of Valsartan plus Hydrochlorothiazide treatment being cost-effective was greater than the probability of the Valsartan being cost-effective. CONCLUSIONS: The combination therapy of Valsartan plus Hydrochlorothiazide for hypertension was found to be more cost-effective than treatment using Valsartan only at all levels of willingness-to-pay for adults in the US.