OBJECTIVES: Pharmacoeconomical evaluation of chelation therapy of transfusional hemosiderosis. A comparison between deferasirox and deferoxamine. METHODS: An evaluation was performed from the Mexican public health system using a computational model that simulates the evolution of patients with transfusional hemosiderosis according to the risks associated with the levels of serum ferritin. Three possible states of health were defined: alive without complications, alive with cardiac disease, and death. The transition from one state to another was reproduced in a model of Markov with annual cycles with a temporary horizon of 25 years. A Student's t -test was performed to compare the results of the two active treatments. RESULTS: The projection of life expectancy up to 30 years of age, according to the level of serum ferritin showed that life expectancy of those patients without chelation therapy who surpass the 1500 µg/mL is considerably reduced, losing around 10 years of life compared to patients who maintain lower levels of ferritin (p<0.001). When comparing just the cost of both chelators with respect to the increase in the life expectancy, there is no difference in the cost per year of life gained with Deferasirox US$5,415.15 IC95% (US$4,192.80-US$6,637.50) and Deferoxamine US$6,211.89 IC95% (US$4,072.56-US$8,351.21) p=0.158. Nevertheless Deferasirox is cost-effective with respect to not applying chelation therapy and Deferoxamine increasing the QALYs in 11.98 (US$32,429.16 per QALY) and 6.1 (dominant strategy) respectively. CONCLUSION: Deferasirox as chelation therapy is cost-effective compared to deferoxamine and no chelation therapy.