OBJECTIVE: The aim of this study was to compare the costs, efficacy and safety of basiliximab (Simulect) versus Thymoglobuline in the treatment of renal transplant induction. METHODS: We carried out an economic evaluation based on the data from clinical trial CHI-F-02. A total of 100 patients, fifty in each group, were recruited from nine sites across France. We estimated the direct medical costs of two strategies of renal transplant induction therapy incurred over six months in a piggy-back approach. Direct medical costs covered medications, hospital stays, dialysis, consultations and examinations not scheduled by the protocol. As both treatments offer the same efficacy, we ran a cost-minimisation study. The cost of care was analysed from a hospital perspective. Wilcoxon rank sum tests were performed to analyse the cost differences between the two strategies. RESULTS: The study showed a significant reduction in the duration of initial hospital stay in the Simulect arm, as well as a significant reduction in the number of infectious episodes. Therefore, although the average cost of treatment with Simulect appears slightly higher than the cost with Thymoglobuline (2 964 versus 2 298 Euros), the cost of initial hospitalisation is significantly lower in the Simulect arm (10 900 versus 11 967 Euros, p = .02). Furthermore the mean cost of infectious episodes is significantly lower in the Simulect arm (1 056 versus 1 790 Euros, p = .03). CMV infection accounts for 30% of this cost in the Simulect arm and 53% in the Thymoglobuline arm with a significantly different cost (p = .01). CONCLUSION: In terms of direct medical costs, this study shows a saving of 1 067 Euros per patient in the Simulect arm, which compensates for the initial higher price of this immunosuppressive drug.