INTRODUCTION:Atrial fibrillation (AF) is the most common arrhythmia in the world and it affects around 1% of the world´s population. There are approximately 1.5 million people, in Brazil, that have AF.  AF is the fifth cause of hospitalization in the Public Health System. AF patients have an increased risk of developing an ischemic stroke than patients without AF. Current treatment for AF are vitamin K antagonist (AVKs), antiplatelet agents, acetylsalicylic acid (AAS) and the Oral Anticoagulants – NOACs (rivaroxaban, dabigatran and apixaban). OBJECTIVES: Evaluate the cost-effectiveness of apixaban versus other NOACs and warfarin, during hospitalization in the private Brazilian health system. METHODS: A cost-effectiveness analysis was performed from the hospital perspective in the private health care system in Brazil. Medications are reimbursed during hospitalization. Inclusion for study analysis were patients with an atrial fibrillation diagnosis, mean age 70-years-old, high risk of stroke and no anticoagulation contraindication. Medications used in this analysis were: apixaban 5mg, dabigratan 150mg, rivaroxaban 20mg and warfarin. Clinical outcomes were life years gained, life years gained adjusted per quality of life, and direct medical costs to the treatment. A Markov model was used to perform the cost-effectiveness analysis. The costs were based on CMED´s price list from 2014 and on specialist panel. RESULTS: Total treatment costs are R$ 29.937,31 for apixaban, R$ 32.465,45 for dabigatran, R$ 38.955,79 for rivaroxaban, R$ 42.710,51 for warfarin. Incremental costs were -R$ 2.528,14 for dabigatran, -R$ 9.018,48 for rivaroxaban, -R$ 12.773,20 for warfarin. Incremental effectiveness and incremental QALY were favorable for apixaban compared to the other medications. CONCLUSIONS: In the scenario where there is reimbursement of medication during hospitalization for the treatment of an AF event, apixaban as anticoagulant therapy for stroke prevention in nonvalvular AF patients, was shown to be cost-saving compared to 3 noted comparators.