OBJECTIVES Clinical evidence has demonstrated that considerable differences exist among various ARBs in terms of safety and efficacy. These differences can lead to diverse economic outcomes depending on the chosen intervention. This analysis was aimed to assess the cost-effectiveness of ARBs available in the Colombian market. METHODS We performed a cost-effectiveness ratio analysis of ARBs in Colombia. A systematic review was performed on available evidence. Head-to-head studies comparing Irbesartan with other ARBs were included and costs were evaluated based on a Colombian pricelist publication. Cost-effectiveness ratio was finally calculated with the efficacy of interventions (systolic and diastolic mmHg reduction) in the analyzed trials. A sensitivity analysis was performed. RESULTS Based on Mancia et al. [BloodPressMonit 2002;7: 135–42] and drug cost in the Colombian market, cost-effectiveness for Irbesartan 150mg was U$10.42 per mmHg reduced in systolic blood pressure (SBP) and US$18 for diastolic blood pressure (DBP) compared with US$18.53 in DBP and US$28.72 for SBP with Valsartan (80mg). According to Bobrie et al. [AmJHypertens 2005;18:1482-8] the cost effectiveness ratio for Irbesartan/Hydrochlorothiazide was US$8.97 (SBP) and US$12.28 (DBP) per mmHg reduced compared with US$12.72 (SBP) and US$18.22 (DBP) for Valsartan/Hydrochlorothiazide. The results based on Oparil et al. [JClinH 2001;3:283-318] were US$13.26 (SBP) U$17.81 (DBP) for Irbesartan 150mg compared with U$19.09 (SBP) US$28.27 (DBP) for Losartan 50mg. Results from analysis performed with Kassler-Taub [AJH 1998;11:445-53] were US$820 (SBP) and U$11.50 (DBP) for Irbesartan 300mg compared with US$13.41 (SBP) and $17.41 (DBP) for Losartan 100mg. Finally, based on the Negro et al. [JEndocrinolInvest. 2006;29:957-61] the results were $23.02 (SBP) and US$30.42 (DBP) compared with US$27.95 (SBP) US$32.67 (DBP) for Telmisartan 80mg. CONCLUSIONS This analysis shows that ARBs have different economic outcomes regarding hypertension treatment. Irbesartan shows a good cost-effectiveness ratio compared with other ARBs in the Colombian context.