OBJECTIVES: To evaluate the clinical outcomes and costs of sertindole versus risperidone in the treatment of schizophrenia in Poland, when considering the ECG measurements required for prescribing sertindole. METHODS: A 6-month cost analysis of a randomized, double-blind, parallel-group, flexible-dose, multi-centre study was performed, for which the efficacy and tolerability of sertindole were directly compared with risperidone . The health outcomes observed in this clinical trial were percentage of patients experiencing response (defined as a 50 % reduction on the PANSS); experiencing EPS-related adverse events (AEs); and experiencing insomnia/agitation as an adverse event. For the cost analysis these were converted into 6-month rates and associated with a treatment cost. To estimate the total cost of treatment of schizophrenia in Poland a survey among 5 Polish clinical experts was conducted assessing the resource utilization for responding and non-responding patients, and for treatment of the adverse events. The cost of treatment included the cost of the antipsychotic agent, the treatment of the adverse events, and the cost of response or non-response. RESULTS: The 12-week health outcomes observed in the clinical trial were: response rates of 42.2% and 32.9% for sertindole and risperidone, respectively; 19% and 28% of patients experiencing EPS-related AEs for sertindole and risperidone, respectively; and 9.3% and 12.4% of patients experiencing insomnia/agitation as an adverse event for sertindole and risperidone, respectively. The total estimated 6-month costs of treating a patient in Poland responding to antipsychotic treatment is 10.046 PLN, and for a non-responding patient 25.929 PLN. When the health outcomes are extrapolated to 6 months, and the 6-month costs are applied, the total cost of 6-month treatment with sertindole is 18.305 PLN as compared with 19.448 PLN with risperidone. CONCLUSION: Sertindole is therefore a less costly antipsychotic-treatment option in Poland, despite the additional costs of ECGs (30 PLN).