OBJECTIVES: In the CURE trial, clopidogrel on top of aspirin has been shown to reduce the number of cardiovascular events (CV) defined as myocardial death, myocardial infarction and stroke, compared to aspirin alone by 20% in patients with unstable angina or non-ST-elevated myocardial infarction with an acceptable 1% increase of major bleedings. Since acquisition costs of clopidogrel is greater than aspirin, it is important to evaluate the cost-effectiveness of this strategy in Mexico. METHODS: Costs were elicited from the IMSS mainly. (Social Security System, 2005). A group of experts identified the resource used by patients during a CV event. Study drug and concomitant medications costs were calculated based on the treatment duration reported in CURE, and costs of adverse events were included. Effectiveness was measured as the total number of events avoided. Sensitivity analyses were performed on the mean costs of events and complications. RESULTS: The mean cost per patient was US$10,614 for the clopidogrel arm and $10,492 for aspirin. The incremental cost was higher due to drug acquisition costs. Treatment with the clopidogrel strategy reduced the number of events by 0.020 (0.1315 vs. 0.1114); resulting in an incremental cost-effectiveness ratio (ICER) of $6,070/event avoided. In the sub-analysis of patients who underwent PCI (PCI-CURE), the total cost reached $10,910 and $10,721 for the clopidogrel and the aspirin strategy, respectively while the number of events were 0.1165 with the clopidogrel strategy and 0.1517 in the aspirin alone arm; resulting in an ICER of $5,369/event avoided. The sensitivity analysis highlighted that the maximum ICER in the CURE analysis was $15,526, using the lowest cost/event reported and $9,905/event avoided in PCI-CURE sub-analysis. CONCLUSION: When comparing the ICER with the acceptability threshold recommended by WHO (i.e., ICER<3xGDP per capita ($30,177), clopidogrel on top of aspirin is highly cost-effective in UA/NSTEMI patients within IMSS Mexico.