The CURE trial showed a 20 % risk reduction of suffering from stroke, myocardial infarction or cardiovascular death in patients with acute coronary syndrome without ST-segment elevation treated with clopidogrel on top of standard therapy including acetylsalicylic acid (ASA) compared to standard therapy alone. We thought to evaluate the incremental cost-effectiveness of this therapeutic strategy in Austria. A Markov model with six states (at risk, first year with stroke, following years with stroke, first year with new MI, following years with new MI and death) was used. Intervention, i.e. treatment with clopidogrel, was studied for a period of 12 months (maximum follow-up in the trial). Costs and effects of the intervention were annualized based on the 9-month average follow-up in the CURE trial. Resource use for different health states was estimated by Austrian experts, associated costs were based on published data for Austrian fees. Annual costs for clopidogrel treatment and savings due to initial hospitalisation were taken from a former short-term cost-effectiveness analysis. In the base case, simulations were performed for a cohort consisting of 61.3 % men (similar to that of the trial, average age 64 years). LYS (life-year saved) was used as the measure of effectiveness. Costs and effects were discounted at 3 %. The model predicts an incremental survival of 0.12 years, when treating patients with acute coronary syndrome for 12 months with clopidogrel on top of standard therapy. If both direct and indirect costs are evaluated the costs per life-year saved are € 4,146. Using the upper bound of the 95 % CI of the relative risk in the CURE trial, the ratios are € 2,566/LYS and € 9,676/LYS. A 12-month therapy with clopidogrel on top of standard therapy including ASA in patients with acute coronary syndrome can be regarded as cost-effective from a societal perspective in Austria.