OBJECTIVES: The CURE trial demonstrated that clopidogrel on top of aspirin reduces the number of cardiovascular events (CV) compared to aspirin alone by 20% in patients with unstable angina or non-ST-elevated myocardial infarction compared to aspirin alone with an acceptable 1% increase of major bleedings. Based on this result, a long-term cost-effectiveness analysis was performed in Mexico. METHODS: An expert panel identified the resource used by patients suffering from a stroke or an acute MI, according to local practices. Costs were elicited from the IMSS healthcare institutions. The yearly costs included the acute and follow-up costs of events, including bleedings. Indirect costs were calculated using the time of work lost. The effectiveness measure was survival. The cost-effectiveness analysis used the societal perspective and incremental cost-effectiveness ratios (ICER) were calculated using a long-term Markov model. A 3% discount rate was applied for costs and outcomes. Sensitivity analysis was performed on the discount rate and the acute events' costs. RESULTS: The model yielded greater direct costs for the clopidogrel strategy ($12,155) vs. aspirin alone (US$11,821) and indirect costs were $164 versus $206 respectively. Total costs in the two arms were $12,319 for the clopidogrel strategy and $12,027 for aspirin alone. Treatment with the clopidogrel strategy resulted in a longer survival compared to aspirin (9.76 life-year gained (LYG) vs. 9.65LYG, respectively). Therefore, the incremental cost-effectiveness ratio of the clopidogrel strategy was $3350/LYG for direct costs and $2938/LYG for total costs. The sensitivity analysis indicated a maximum ICER of $6,570/LYG using a 5% discount rate and the lowest cost reported per event. CONCLUSION: In this analysis, the cost per life year gained is lower the recommended threshold of acceptability defined by WHO (3xGDP per capita (US$30,177), indicating that Clopidogrel on top of aspirin is highly cost-effective in patients with UA/NSTEMI within the IMSS.