OBJECTIVES: To clarify whether the therapy of liver cirrhosis with silymarin shows a higher cost-effectiveness than a treatment without from of the third party payerxs perspective. METHODS: To calculate the incremental cost-effectiveness based upon a clinical study, the liver-related mortality rates of patients with liver cirrhosis after four years, treated with or without silymarin, were compared. Adverse effects (AE) and adverse drug reactions (ADR) were also be considered. Comparative parameters were costs, effectiveness and tolerability of both alternatives. Costs were generated by the drug therapy of liver cirrhosis, medical care, and treatments of AE and ADR, which were derived from previous studies and portrayed in a core-model. The calculation of the model was performed by utilising the program DATA Professional. Two sensitivity-analyses were conducted. RESULTS: For liver-related mortality total costs of €5467 for silymarin and €3333 without silymarin were generated. The effectiveness-adjusted costs were calculated at €5970 for silymarin and €4009 for treatment without silymarin. This entails that for the longer survival time of 9.12 months, incremental costs of €1961 were calculated per silymarin patient. However, as an effect, less AEs occurred and longer survival of patients could be achieved with silymarin treatment of liver cirrhosis. CONCLUSION: With silymarin treatment of liver cirrhosis less AEs and longer survival of patients could be achieved. By considering the concept of prolonged life, cost amounting to €2580 were estimated per life year gained (lyg).