OBJECTIVES: Atrial Fibrillation (AF) affects about 2% of the population and increases 5-fold the risk of stroke and systemic embolism. This risk is managed with vitamin K antagonists (VKA) or aspirin for patients according to their suitability to receive oral anticoagulants (OA) but with several limitations. Therefore, novel OAs have become a treatment option. Apixaban is the most recent drug approved for thrombotic prevention in AF. Our aim is to estimate the cost-effectiveness (CE) of apixaban in AF in Argentina.  METHODS: We conducted a literature review of published epidemiological AF, and stroke data from Argentina. Data about  apixaban, warfarin, rivaroxaban, dabigatran and aspirin were obtained from published trials and indirect comparisons. Two Delphi Panels, with local experts representing private, public and social security health subsectors were held and reviewed and validated data collected and provided information on local treatment patterns. Costs, expressed in 2012U$S, were gathered from published reports and a local database. Apixaban was compared with each available AF treatment option allocating them into a simulated cohort of 1,000 patients per treatment group (according with their suitability for OA) over a lifetime horizon using an MS EXCEL based Markov model. We adopted payer´s perspective reporting weighted mean costs for QALY gained. CE threshold for Argentina was considered as per WHO-CHOICE and World Bank data (ranging from 9740 to 29220U$S) RESULTS: For the suitable population, the cost per QALY gained with apixaban was U$S 9938 and 1131 versus warfarin and dabigatran 150 mg respectively, and dominant compared to dabigatran 110 mg and rivaroxaban. For the unsuitable population, apixaban was dominant compared to available alternatives: aspirin, dabigatran 110 mg, dabigatran 150 mg, and rivaroxaban CONCLUSIONS: on the model using local inputs, apixaban is dominant or cost-effective according to local CE thresholds becoming the treatment choice in Argentina both in the suitable and unsuitable populations