OBJECTIVES: To develop cost-analysis of MEDIHONEY CALCIUM ALGINATE (MEDIHONEY) versus ACQUACEL AG (AG) dressings for chronic-wound treatment in adults, from perspective of Brazilian public payers. METHODS: Data from Brazilian Hospital Information System from October 2013 to September 2014 was used to define the annual number of hospital admissions due to chronic wounds (only non-surgical records with L97.909 ICD-10 code included). The model assumed that patients are discharged at the time their wounds heal. No critically ill patients in ICUs were included. Only patients above 20 years old were included. Unit cost obtained from Brazilian official price lists. RESULTS: The model estimated costs for the inpatient period assuming one dressing change every 3 days for MEDIHONEY and AG, considering in both cases a similar size. Cost per dressing change was estimated as USD35.80 and US31.85 for AG and MEDIHONEY, with mean healing time of 53 and 31 days, respectively. Overall treatment costs were USD4,020,805.30 and USD3,577,169.00 according to the LOS and USD632.46 and USD329.12 according to MHT/patient for AG and MEDIHONEY, respectively. MEDIHONEY-related incremental costs were USD31,492,834 indicating a cost-saving profile. Adopting MEDIHONEY as wound management protocol would save USD29,025,998 for the 2013/2014-cohort. Clinical benefits for use of MEDIHONEY CALCIUM ALGINATE over AG include decreased risk of hypersensitivity to compounds, MEDIHONEY treatment is appropriate throughout wound healing process and MEDIHONEY does not induce microbial resistance. CONCLUSIONS: MEDIHONEY dressing demonstrates cost-effectiveness when compared to AG dressings. These results reinforce the need for evidence-based decision making and rational resource allocation; in addition to further studies including clinical outcomes data.