OBJECTIVES: Determine whether adalimumab reduces costs for the public health sector in the treatment of moderate to severe active ulcerative colitis in adult patients who have had an inadequate response to conventional therapy in comparison with infliximab. METHODS: Adalimumab was considered comparable with infliximab in the treatment of Ulcerative Colitis through a systematic review of the literature. A cost minimization analysis was then considered appropriate under the perspective of the public health care system in Mexico and a time horizon of five years. Direct drug and administration costs were considered. Univariate and multivariate probabilistic sensitivity analyses were performed. Finally, we assessed the budget impact of potential savings. RESULTS: The model results showed that the cost with adalimumab treatment for five years (using an annual discount rate of 5%) is $ 96,365.87 (11.2%) lower than the total cost with infliximab. This generates savings to the health system. Results have a high sensitivity to patient weight, but expected costs in all simulated populations are lower with adalimumab. In the base case, the present value of the 5-year budget impact with a discount rate of 5% represents savings around $ 348,748,074.14 pesos if adalimumab is used in 100% of estimated prevalence in Mexico. CONCLUSIONS: Adalimumab proved to be an alternative that minimizes expected costs under the investigated scenarios given the evidence of comparable efficacy versus infliximab. Also, savings allow greater access to care for patients with UC, benefiting the health institution, not only by improving the quality of care with an innovative therapy but also by allowing significant savings that could be used to treat a larger number of patients.