OBJECTIVES::  To perform a cost-effectiveness analysis of systemic arterial hypertension treatment conjugated with Pharmaceutical Care (PC) compared to conventional treatment offered by the Public Health System (PHS). METHODS::  This is a cost-effectiveness study nested to a clinical trial conducted over seven years, in which a PC program attended hypertensive patients for a period of one year. This study was conducted from the perspective of the Brazilian PHS. The period of conventional healthcare prior to the program was called Pre-PC, the year of assistance by the program and the years after discharge of the patients were called PC and Post-PC, respectively. Blood pressure control was the outcome measured and the direct and non-direct medical costs were considered. Incremental Net Benefit (INB) was used to detect the sensitivity of the results of the incremental cost effectiveness ratio (ICER). Monte Carlo sensitivity analysis was performed for the costs variation. The threshold of three times Gross Domestic Product per capita was considered. RESULTS::  The PC program attended 104 patients. The mean cost-effectiveness ratio (CER) was US$ 364.65, US$ 415.39, and US$ 231.14 for the CER_Pre-PC, CER_PC, and CER_Post-PC periods, respectively. PC was dominant for two years in the post-PC period compared with the Pre-PC year. The incremental cost analysis showed that in the PC period the ICER was US$ 478.41, and in the post PC period was US$ 42.95. The values of -US$ 16.09 to US$ 13,400.94 represented a range that indicates that the results are sensitive to assign a value to the willingness to pay by the INB. Monte Carlo sensitivity analysis showed US$ 605.09 and US$ 128.03 for the mean ICER_PC and ICER_Post-PC, reaching US$ 1,725.00 and US$ 740.00, respectively. CONCLUSIONS::  The highest value for the ICER did not exceed the cost-effectiveness threshold that showed PC was a cost effective health technology.