OBJECTIVES: To compare the economic impact of the treatment of acromegaly with two different somatostatin analogues in Brazil, after the decision of reimbursement of the therapeutic class by the Brazilian Public Health Care System (SUS) in 2002. METHODS: Acromegaly treatment cost estimation was based on secondary data and on a decision analytical model developed from the Brazilian Public Health Care System Clinical Guideline for Acromegaly. The strategies of using somatostatin analogues in depot presentations (octreotide LAR or lanreotide SR) were compared. The model followed a hypothetical cohort of 276 patients diagnosed with acromegaly for two years. Costing included direct medical costs, composed by drugs, consultations, monitoring tests, radiotherapy and hospitalisation, under the Brazilian Public Health Care System perspective. Data were extracted from national and international literature, and from administrative official databases (Ambulatory Information System, Hospital Information System, Mortality Information System). Costs are reported in 2005 Reais (R$) and Euros (€). Official exchange rate was used for currency conversion (2.77 BRL = 1 EUR, Brazilian Central Bank). Sensitivity analysis was conducted. RESULTS: Octreotide LAR treatment strategy presented net savings of R$10,448,324 (€3,771,958) to the Brazilian Public Health Care System when compared to lanreotide SR treatment strategy in a period of two years. Average annual cost per patient was R$27,359  (€9,877) for octreotide LAR and R$46,287  (€$16,710) for lanreotide SR. Net savings per patient per year with octreotide LAR were R$18,928 (€6,833). Sensitivity analysis did not revert results of net savings.CONCLUSIONS: Monitoring of acromegaly treatment costs after reimbursement for somatostatin analogues showed that octreotide LAR is cost-saving compared to lanreotide SR in Brazil under the Public Health Care System perspective.