The results of SOLVID trial demonstrating the survival benefit of enelapril (E) treatment of congestive heart failure (CHF) (NYHA III-IV, EF <35%) prompted us to perform the present analysis. OBJECTIVE: Cost-efectiveness analysis of E versus placebo in conjunction with standard treatment, in the management of CHF in Poland. METHODS: SOLVD results are used to estimate the increase in survival and the reduction in the number of hospitalisation arising from the use of E in CHF management. Life-years saved are estimated on the basis of original patient data from SOLVD, using survival curves analysis. Direct medical costs are estimated on the basis of current treatment patterns in Poland. The perspective of the health care payers and time frame of 4 years was taken. The decision model was used to quantite risk benefits, and costc of alternative treatment. One-way and multi-way sensitivity Monte Carlo analysis was performed. RESULTS: E increases mean survival by 1,88 month/patient/4 years and is cost saving, reducing direct medical costs for CHF patient (330 z_ = $ 80.5/4 years). Sensitivity analysis indicated, that therapy with E. remained cost saving even when drug cost was increased 2 times and the risk of hospitalisation in E group increased by 20%. When 3 variables (frequency, hospitalisation cost, live-years-saved) were changed simultaneously, in 77.2% simulations ICER value was negative, and 90% were in range: -16 863/5 587 PLN. CONCLUSION: addition of E to conventional CHF management in Poland should improve survival and may provide a net reduction in treatment costs. There are 100 000 hospitalisations/year attributable to CHF in Poland.