OBJECTIVES: Aortic valve stenosis is a progressive valvular heart disease with a standard care that involves a major open surgery. However, part of the patients is ineligible for surgery, therefore drug therapy is the only option available. Once TAVI is a less invasive surgical option, clinical trials demonstrated significant benefits, although procedure and device are costly. The aim of this study was to estimate the incremental budget impact with this new procedure incorporation under the SUS perspective. METHODS: The BIA was based on a Markov model with quarterly cycles and 5-year time horizon in order to predict clinical and economic outcomes in a scenario with TAVI incorporation compared to the actual scenario – drug therapy (amiodarone, furosemide and digoxin) with or without aortic balloon valvoplasty. Epidemiological data were obtained from DATASUS and survival was extrapolated from PARTNER cohort B trial by using a Weibull distribution. Resource use, also gathered from this trial, included early perioperative complications (30 days) and late events (rehospitalization, dialysis, stroke, pacemaker implantation and major vascular complications). Costs were taken from the official Brazilian public official lists (DATASUS and BPS). Market-share data was obtained from Sociedade Brasileira de Hemodinâmica e Cardiologia Intervencionista. RESULTS: The estimated number of Brazilian patients eligible for SSVS treatment was 795, 922, 1,180, 1,335 and 1,402 respectively for years 1-5 of analysis. Compared to the current scenario, the inclusion of TAVI procedure with a 13% market share during the analysis period shows an additional budget through year 1-5 of 3.5M, 5.0M, 6.7M, 8.1M and 9.4M, consecutively. CONCLUSIONS: The incremental budget impact to include TAVI as a treatment option in the Brazilian Public Healthcare System for SSVS high-risk patients was estimated to be USD 65 million in 5 years.