OBJETIVE: To estimate the cost-effectiveness of 160mg valsartan as an alternative treatment for systemic arterial hypertension as compared with daily doses of 100mg losartan and 80mg telmisartan using a pharmaco-economic analysis. METHODOLOGY: The study was based on a literature review and expert opinion in two phases: the first was a literature search to determine effectiveness expressed as a reduction of mm Hg; the second consisted of a cost-effectiveness analysis. The model used the Mexican Health System perspective. Only direct medical costs were included. Data costs were obtained from published lists of unitary costs for the Health Sector. RESULTS: Following treatment with 160mg valsartan and 100mg losartan for 4 weeks, the mean sitting diastolic blood pressure (MSDBP) was -10.5mm Hg and -9.7mm Hg respectively. The difference was not significantly significant. In the case of valsartan versus 80mg telmisartan, valsartan proved more effectiveness, showing a reduction in systolic and diastolic pressure of -18.6 and -12.1mm Hg respectively as compared with reductions of -10.8 and -8.4mm Hg for telmisartan. The cost analysis did not show any differences in terms of other medical interventions but there was a difference in the cost of the drugs. The monthly cost per patient treated was the lowest with 160mg valsartan at $246.67 Mexican pesos (US$22.42), as compared with $695.60 Mexican pesos (US$63.23) for 100mg losartan and $469.29 ($42.66) for 80mg telmisartan. CONCLUSIONS: Treatment with 160mg valsartan is the least costly with at least the same efficacy in reducing arterial pressure as 100mg daily dose of losartan. In the case of 80mg telmisartan, 160mg valsartan was more effective with a lower cost. It has been shown that 160mg valsartan is the preferred treatment in terms of pharmaco-economic parameters compared with the other options studied. Sensitivity analysis confirmed the results obtained in the base case.