OBJECTIVES Dasatinib 100mg is the optimized and recommended initial dose for patients with CML in chronic phase in Mexico. However, little is known on its cost effectiveness when compared with recent treatment alternatives in the market such as nilotinib 800mg. This study addresses this question under the Mexican health care perspective. METHODS A cost utility life-time Markov model based was used to calculate the incremental cost per Quality Adjusted Life Year (QALY) of the compared therapies. The model follows patients with CML in CP considering the different phases of the disease progression including accelerated and blast health states. Initial best response as defined by the START (SRC/ABL Tyrosine Kinase Inhibition Activity Research Trials) studies determined the pathway the patients will follow within the model. The researchers did not identify any clinical trials that compared dasatinib directly with the comparator, and therefore an indirect comparison was performed. For the indirect comparison all the relevant published efficacy literature was used. Transition probabilities and QALYs were estimated from published international literature. Estimates of the use of health care resources by CML patients in Mexico came from a previously reported study using the Delphi Panel technique. Costs of drugs and other health care treatments were primarily obtained from IMSS published information and discounted at 5 % (using the recent published guidelines by the Mexican National Health Council). Sensitivity analysis was performed. RESULTS The economic evaluation revealed that dasatinib was more effective (QALY difference of 0.2) and less costly (-US$41,329) than nilotinib therapy. These findings were robust to deterministic sensitivity analysis. CONCLUSIONS In México, Dasatinib is a cost effective therapy for the management of Imatinib resistant patients with CML in the chronic phase. Collection of long term health care efficacy data will help to validate these results.