OBJECTIVES:Opioids comprise the main option in the management of moderate-to-severe cancer pain. Different opioids are used in rotation to eliminate tolerance and opioid side effects that limit increasing dose. Since there are only two non-parenteral opioids –morphine and fentanyl– in Turkey, pain control with rotation might not be successfully done and invasive treatment modalities are to be selected much earlier than optimal. The aim of the study is to evaluate the contribution of the addition of a new long-acting oral opioid (OROS hydromorphone) into the current opioid market, with regard to the cost of treatment in moderate-to-severe cancer pain.METHODS:Model: Decision tree modeling to compare the current two-opioid-market with the hypothetical three-opioid-market, is used in the calculation of costs. Patients are treated with rotation of two and three opioids in the current and hypothetical market respectively. Time horizon is eight weeks. The study has been performed from the healthcare payer perspective.Data sources: The clinical data are acquired from the literature. Prices of medications, discount rates, other costs related to the treatment are obtained from Ministry of Health Drug Price List, Price List of Social Security Institution Health Implementation Guideline Appendix 2/D and 8, respectively.Analysis: Direct medical costs that are considered are the costs of opioids, invasive treatment modalities, side effects, physician visits and hospitalization. Because time horizon is shorter than 1 year, costs are not discounted. The results are presented as total costs of alternatives.RESULTS:Costs of treatment are calculated as €1528/patient for the current two-opioid-market and €1070€/patient for hypothetical three-opioid-market. The amount of saving is €458/patient.CONCLUSIONS:Inclusion of OROS hydromorphine into the Turkish market will both increase the chance of patients be treated with non-parenteral opioids without need to non-invasive methods and also provide saving in the total medical costs of treatment.