OBJECTIVES: There are three subcutaneous biologic therapies approved for psoriasis in Colombia: ustekinumab, etanercept and adalimumab. A network meta-analysis demonstrates a better incremental efficacy of ustekinumab versus the other two alternatives. However, considering that the medication cost is higher for ustekinumab, this analysis evaluates the cost-effectiveness and budget impact of the three alternatives assuming the Colombian Health System perspective. METHODS: A decision tree was designed from the payer perspective to estimate costs and benefits for one year time horizon. Clinical data were obtained from a network meta-analysis in order to model treatment response and second line treatment progression. Benefits were measured as probability of achieving a PASI 50 response at the end of 12 weeks of treatment. Only direct costs were considered using national tariffs and prices from Ministry of Health medication database. For budget impact analysys a target population of 550 patients is estimated and three scenarios of ustekinumab adoption were assessed: current scenario (13% market share), middle penetration scenario (28% market share) and a high penetration scenario (50% of market share). No discount rate was used.  Exchange rate  (1 USD = 1,794 COP).  RESULTS: Total cost per patient (USD): ustekinumab (23,229), etanercept (25,079) and adalimumab (23,825). PASI 50 response (% of patients): ustekinumab (90%), etanercept (76%) and adalimumab (81%). Cost per responder patient: ustekinumab (25,810), etanercept (32,999) and adalimumab (29414). Budget Impact (USD):  current scenario (13,387,999), middle penetration scenario (13,262,955) and high penetration scenario (13,114,969). CONCLUSIONS:  When a subcutaneous biologic is considered as the first line choice of treatment for psoriasis, ustekinumab is the prefered first line therapy. Ustekinumab progressive adoption, in the Colombian Health System, demonstrates potential savings driven by its better efficacy and less probability of requiring a second line more expensive treatment.