OBJECTIVES: Catheter-based renal denervation (RDN) is an effective and durable therapy option for patients with treatment resistant hypertension (TR-HTN). Based on results of the Symplicity HTN-2 trial (NCT00888433), Geisler et al. (2012) developed a Markov model to quantify the cost effectiveness of RDN plus standard of care (SOC) vs SOC alone in the US healthcare setting. The objective of this analysis is to assess the cost-effectiveness of RDN in patients with TR-HTN from the Australian payer perspective. METHODS: Geisler methods were largely retained but life tables, resource use, costs and discount rates were revised to reflect Australian parameters. Importantly, the treatment effect of RDN was based on a meta-analysis of all studies (regardless of catheter used) enrolling TR-HTN patients (SBP ≥ 160 mmHg despite >3 anti-hypertensive drugs including a diuretic).  The model consisted of 30 health states and employed multivariate risk equations from large-scale cohort studies to calculate transition probabilities of events and event mortality. Discounted (5%) costs and outcomes were calculated over a lifetime horizon. RESULTS: The weighted mean decrease in office-based SBP over 6 months was -28.1 mmHg (95% CI: -24.5 to -31.6).  The RDN procedure cost ($10,724.22) was partially offset by lower event costs – primarily through a reduced incidence of stroke (-0.0559) and MI (-0.0524).  RDN was associated with higher incremental costs ($5,951.04) and additional QALYs (0.4296) resulting in an incremental cost per QALY of $13,852. Sensitivity analyses demonstrated reliability of the base case results across a wide range of assumptions. CONCLUSIONS: Consideration of both clinical and economic evaluations may be necessary to inform reimbursement decision making. Based upon this analysis, RDN is a cost effective treatment option for patients with rHTN in Australia. However, this conclusion is dependent upon the magnitude of SBP reduction with RDN and assumptions related to long term patient outcomes.