OBJECTIVES: Existing randomized, placebo-controlled clinical trials demonstrated that the triple combination of peginterferon (PEG), ribavirin (RBV) and protease inhibitors (PI) - telaprevir (TPV) and boceprevir (BPV)  was more efficacious than standard therapy of PEG-RBV alone in treatment of patients with genotype 1 chronic hepatitis C (GI HCV). The objective of this study was to evaluate the cost-effectiveness of triple therapy in both treatment-naive and treatment-experienced patients in Казахстан.  METHODS: A Markov-model was created to study the longterm clinical benefits and the cost-effectiveness of the triple therapy from the Kazakh payer perspective. Health states within the model were defined using METAVIR fibrosis scores (F0–F4), decompensated cirrhosis (DC), hepatocellular carcinoma (HCC), liver trasnsplant (LT), and liver-realted deaths (LD). Efficacy data was estimated using ADVANCE, RELEASE, RESPOND-2, and SPRINT-2 studies, and disease progression rates and utilities used in the model were estimated from published studies. Data on probability of liver-transplantation and cost estimates were based on an analysis of the Kazakhstan's Ministry of Health Committee of payment of medical services.. Costs and benefits were discounted at 5%. RESULTS: Triple therapy with protease inhibitors, is ensures to increase the life expectancy by 0.98 and 2.39 years and the quality-adjusted life years (QALY) by 0.59 and 1.13 in comparison with treatment with PEG-RBV in treatment-naive and treatment-experienced patients, respectively. The corresponding incremental cost-effectiveness ratios were USD26,860 and USD20,042 per QALY on an average, respectively. The lifetime incidence of severe liver disease events (DC, HCC, LT, LD) reduced by 43% and 65% in these patient groups in comparison with treatment with PEG-RBV alone. CONCLUSIONS: The addition PI of  to standard therapy for the treatment of patients with G1 chronic HCV infection in Kazakhstan is cost-effective using a commonly used willingness to pay threshold of USD37,272. Using BPV demonstrated more cost effective, than TPV.