OBJECTIVES: Idiopathic pulmonary fibrosis is a chronic, progressive, and fatal lung disease that is characterized by irreversible loss of lung function. Pirfenidone is an oral antifibrotic therapy for the treatment of idiopathic pulmonary fibrosis with significant effects on reducing disease progression and exacerbations. The objective of this analysis is developing a cost-effectiveness analysis comparing pirfenidone vsthe current pharmacological alternatives available. METHODS: Pirfenidone is compared to Prednisone, azathioprine, and N-acetylcysteine in a cost-effectiveness analysis. A Markov model was developed to estimate incremental costs and benefits in this population of patients using a 1 year time horizon. The model comprised the following mutually exclusive health states: free progression, progression (defined as the time to the first occurrence of exacerbation) and death. Transition probabilities were obtained from clinical trials and the scientific literature. Disease costs and exacerbation costs derived from the IMSS' Groups Related to Diagnosis (GRD). Costs were converted to UD dollars (1 USD = 15.42 MXN). The perspective of the analysis was that of the Mexican Social Security Institute (IMSS). RESULTS: Pirfenidone offers statistically significant improvements in forced vital capacity, 6 minute walk distance (6MWD) and progression free survival. Patientes treated with Pirfenidone showed a 51.8% change in the predicted forced vital capacity which reduced disease progression in 234% compared to Prednisone, azathioprine and N-acetylcysteine at a cost of $121,293 USD vs $154,582 USD respectively. When measuring exacerbarions, pirfenidone group avoided 14.3 exacerbations for a saving of 422,472 USD.  CONCLUSIONS: Using pirfenidone for treating idiopathic pulmonary fibrosis is a cost-effective alternative versus the current treatments available. The results also suggests that the economic benefit of ulipristal in avoiding exacerbations can lead to important savings not only for the IMSS but for the Mexican Health System as well.