OBJECTIVES: The CURE trial showed that clopidogrel on top of standard therapy (including aspirin, ASA) decreases the risk of myocardial infarction, stroke and cardiovascular death by 20% in patients with acute coronary syndromes (ACS) without ST-elevation. The purpose of this study was to evaluate the cost-effectiveness of adding clopidogrel to standard treatment in Hungary. METHODS: A Markov model with six states (at risk, first year with stroke, following years with stroke, first year with new MI, following years with new MI and death) was used. to determine the cost-effectiveness of clopidogrel, which was expressed in costs per life-years saved. Life time horizont was applied. Effectiveness data were derived from the CURE study, while the long-term outcomes were based on epidemiological estimates concerning age specific event rates and case fatality rates. In the analysis only direct costs were included, which were all assessed from Hungarian sources. Costs were applied at a 2004 year price level. The perspective of the National Health Insurance Fund was used. Discount rates applied were 5-5% for costs and benefits also. RESULTS: When clopidogrel was added to standard therapy (including ASA), 101 years of life were saved per 1000 patients. The incremental cost was 618 Euros (154,433 HUF) per patient, and the ICER of clopidogrel on top of standard therapy was 6113 Euros (1,528,231 HUF) per life year saved. Sensitivity analyses showed that the results are more sensitive to the discount rates used and survival data and less sensitive to the costs of vascular events. CONCLUSION: Clopidogrel treatment is cost-effective on top of standard therapy including ASA in patients with acute coronary syndromes without ST-segment elevation in Hungary.