OBJECTIVES: To examine whether fluvoxamine represents value for money in the treatment of social anxiety disorder from the perspective of the NHI.  METHODS: An economic model was used to quantify costs per additional day spent in remission associated with fluvoxamine (150 mg/day) when compared with no pharmacotherapy. Efficacy inputs were based on a 10-week placebo-controlled randomized trial and a 52-week follow-up reported in Asakura et al (2007). Liebowitz Social Anxiety Scale-Japanese Version (LSAS-J) total score (0 to 144; higher score indicating increased severity) and Clinical Global Impression-Improvement scale (CGI-I) (1=very much improved to 7=very much worse) were employed to assess the patient’s response to treatment. Successful response, resulting in remission of the disease, is defined by LSAS-J score of 30 or CGI score of 2 or 1. Area under a curve method was employed to calculate the number of days spent in remission. Time horizon of the model was one year. Only medication costs were included. RESULTS: Patients treated with fluvoxamine were demonstrated to spend additional 33 days or 69 days in remission by using LSAS-J or CGI-I, respectively, when compared with no pharmacotherapy. Costs per additional day spent in remission was ¥1023 using LSAS-J and ¥845 using CGI-I. To meet the estimated WTP per QALY of ¥6.5 million (Ohkusa and Sugawara, 2007), the required level of utility score improvement associated with the disease remission was estimated as around 0.05–0.07. CONCLUSIONS: Fluvoxamine was shown to offer significant improvement in symptoms associated with SAD. Fluvoxamine was also likely to represent a cost-effective strategy. Given that SAD affects academic or occupational functioning, fluvoxamine should also offer considerable indirect cost savings. Hence, the current analysis should be considered as being conservative.