OBJECTIVES: β-Thalassaemia is one of the major public health problems in Thailand. Using appropriate iron chelating agents could prevent thalassemia-related complications which are costly to the health care system. This study aims to evaluate the cost-effectiveness of Deferoxamine (DFO), Deferiprone (DFP), and Desferasirox (DFX) in transfusion-dependent thalassaemia patients from the societal perspective.  METHODS: A Markov model was used to project the life time costs and outcomes represented as quality-adjusted life years (QALYs). Clinical efficacy and safety of all therapeutic options were obtained from a systematic review and clinical trials. Transition probabilities were derived from literatures while costs were obtained from Thai Drug and Medical Supply Information Center,  Diagnostic Related Group (DRG) and other Thai literatures. Discounting rate of 3 percent was used. Incremental cost-effectiveness ratios were presented as values of year 2009. A series of sensitivity analysis and cost effectiveness analysis curve (CEAC) were performed.  RESULTS: Compared with DFO, using DFP is dominant with cost-savings of US$ 91,107 without QALYs gained. Comparing DFX with DFO, the incremental cost was US$ 129,565 and incremental QALY was 5.35 with an incremental cost-effectiveness ratio of US$ 22,463. When compared to DFP, an incremental cost-effectiveness ratio of DFX was US$ 38,258 per QALY. Cost effectiveness analysis curve (CEAC) showed that the probability of DFX being cost-effective was 0% when compared with either DFO or DFP, based on the cost-effectiveness cut-off value of US$ 2,902 per QALY. When compared to DFP, DFX is cost-effective only if DFX cost was lowered from US$ 14.6 to US$ 4 per tablet.  CONCLUSIONS: Our findings suggest that using DFP is cost-saving when compared with the conventional therapy, while using DFX is not cost-effective compared with both DFO and DFP. Policy makers and clinicians may consider using such information for aiding policy decision making process in Thailand.