OBJECTIVES: Wet Age-Related Macular Degeneration (wAMD) is a degenerative disorder of the macula associated with the aging process and one of the main causes of severe and irreversible loss of vision in people older than 40 years. This study sought to estimate and compare the economic and health consequences of intravitreal-aflibercept vs ranibizumab-PRN in the management of patients with wAMD, from the Mexican Institutional Payer Perspective. METHODS: a six-state, monthly cycle Markov model simulated wAMD patients treated with either intravitreal-aflibercept (2mg each 8 weeks after a 3-monthly loading dose injections in the first year, followed by pro re nata (PRN) applications to complete second year) or ranibizumab-PRN (3-montly loading dose injections followed by PRN to complete 2 years). Effectiveness and safety parameters were extracted from international literature. Due lack of head-to-head trials, a Bayesian Network Meta-analysis was conducted with REVMAN 5.1 software to compare outcomes between drugs. Effectiveness measures were the proportion of patients gaining 6+ or 3+ lines of vision (+6L, +3L) and going blind or not-disabled (B, ND). The model assumed that there are only direct medical costs (drug, monitoring/administration, adverse events, and cost of blindness). Both costs and consequences were discounted at 5%/year through a 2-year time horizon. The costs are expressed in 2014 US$ and correspond to Mexican public healthcare institutions. Univariate and probabilistic sensitivity analyses were performed. RESULTS: Total expected costs for each alternative were: intravitreal-aflibercept US$8,636 and ranibizumab-PRN US$11,004. Cost reduction for intravitreal-aflibercept was mainly driven due significant lower total expected monitoring costs (≥30%). Results in effectiveness for each alternative (+6L, +3L, B, ND, respectively) were: intravitreal-aflibercept 3.71%, 21.14%, 3.74%, 0.42% and ranibizumab-PRN 2.37%, 17.63%, 5.29%, 0.20%. CONCLUSIONS: The results suggest that intravitreal-aflibercept is a dominant alternative for the treatment of wAMD, over ranibizumab-PRN in Mexican Patients, from the perspective of the Public Payer.