OBJECTIVES: Cost-Effectiveness analysis of Drug Coated Balloon (DCB) vs. Percutaneous Transluminal Balloon Angioplasty (PTA), Bare Metal Stent (BMS) and Drug Eluting Stent (DES) in the treatment of Peripheral Arterial Disease in lower limbs in Canada. METHODS: An analytical decision model was considered with Target Lesion Restenosis (TLR) Avoided and total cost at the end of two year horizon. An Excel model was developed. The effectiveness data (TLR rates) and distribution of revascularization modalities were obtained from a literature review and budget impact model by Jan et al., which pooled the clinical effectiveness of the four therapies based on published literature (1-3). A payer perspective was assumed. Total costs were taken from reimbursement values charged to payers in Canada. Because effectiveness and cost were taken as unique values at the end of the two years, discount rate was no applied. The sensitivity Univariate analysis was done for DCB vs. PTA. For the Probabilistic Sensitivity Analysis a Monte Carlo Simulation with 1000 iterations was done. RESULTS: TLR Avoided probability with DCB was 0,841 vs. 0,604, 0,731 and 0,806 for PTA, BMS and DES respectively.  DCB total cost was CAD$4.790 vs. CAD$4.735 for PTA, CAD$4.301 for BMS and CAD$6.316 for DES. DCB was dominant to DES, and had an ICER of CAD$231 respect to PTA and CAD$4.435 respect BMS. The Willingness-To-Pay (WTP) acceptability curves show that DCB, compared to other therapies, had a higher probability to be accepted for all the WTP values above CAD$4.200, reaching a probability of 73% for CAD$9.000 WTP value. CONCLUSIONS: DCB was dominant to DES and had an ICER of CAD$231 respect to PTA and CAD$4.435 respect BMS. The univariate sensitivity analysis shows the ICER of DEB vs. PTA was especially sensible to total costs of the therapies and the effectiveness of PTA.