OBJECTIVES: This study aimed to analyze the cost reduction of using hydrocolloid dressing (HCD) versus silver sulfadiazine (SSD) in adults with pressure ulcers in the Brazilian public health system METHODS: A literature search was conducted to gather efficacy data for HCD and SSD. The number of hospitalizations was collected from the Brazilian official public healthcare database (from October 2014 to September 2015). The model assumed that SSD is the current practice in Brazilian public hospitals and patients are discharged at the time their wounds heal. Resource use was estimated through the literature, only direct medical costs were included in the analysis and unit costs were obtained from Brazilian public health system official price lists. RESULTS: A total of 219,976 hospitalizations under L89 IDC were identified in the database. The randomized trial observed mean time to heal of 10.5 and 27.6 days for HCD and SSD, respectively (incremental effectiveness of -17.1 days). Evidence from smaller observational studies have reported intervals to HCD change of up to 14 days, while SSD requires two changes per day. Thus, the model estimated costs for the inpatient period assuming one dressing change for HCD and 28 for SSD. Cost per dressing change was estimated as 17.30BRL (BRL= Brazilian Reais) for HCD and 15.58BRL for SSD and overall treatment costs were 1,367.94BRL and 3,548.26BRL, respectively. Healthcare-related incremental costs were -1.72BRL indicating a cost-saving profile. Benefits in terms of reduction in length of stay were not accounted in this case based scenario. If average public hospital daily charges were included in the cost estimation, savings would reach -2,180.32BRL per patient or -479,617,192.42BRL for the cohort. CONCLUSIONS: HCD dressing has shown higher clinical efficacy when compared to SSD, with fewer overall costs, representing a robust cost reduction profile.