OBJECTIVES: To estimate the resource use and associated cost of treating opioid-induced constipation (OIC) episodes in cancer patients in Sweden where laxatives within current SPC-text have failed. METHODS: Nurses in 3 hospices and 10 home care centers across Sweden with experience in caring for cancer patients on opioid therapy were selected to participate in an interview series. An interview protocol was developed in consultation with an expert. The nurses reported on the frequency of OIC episodes, treatment practices and resource use related to constipation. The cost components included personnel costs (based on time spent on constipation-related tasks), transportation costs (for home care visits) and resource costs. The cost per hour for personnel was based on the average salary levels of applicable medical personnel in Sweden and overhead cost. The average cost per constipation episode was estimated and used to project direct health care cost of OIC in Sweden. RESULTS: The nurses reported that on average 24% of patients in home care and 45% of patients in hospices had a constipation episode every second week or more often with laxatives in labeled doses. The nurses estimated the length of the constipation episode to be between 2 – 5 days. Three steps were identified in the treatment process - increase in dosage of laxatives (100%), provision of suppositories and enemas (40%) and manual disimpaction or bowel investigation/contrast X-ray (3% of cases). Nurses spent on average 3.5 hours ranging across 2 additional visits for treating each episode of OIC. The average cost per episode of OIC was estimated to SEK 1700. Direct health care costs of OIC in cancer patients who have failed laxatives within current SPC-text, were estimated to SEK 40 million per year in Sweden. CONCLUSIONS: Opioid-induced constipation in cancer patients in Sweden is associated with significant resource use and costs.