OBJECTIVES: To compare the potential cost of long-acting treatment with lanreotide vs octreotide for acromegaly using patient treatment characteristics from the PHARMO Record Linkage System (RLS) in the Netherlands. METHODS: A cost minimization model was used to compare the lifetime costs of the SSAs. Data for patients receiving outpatient dispensing of long-acting SSA (2003–2010) were selected from the PHARMO RLS. Acromegalic patients were identified by hospital discharge diagnoses and were stratified by first SSA dispensed during the study period. Dosing and injection intervals were assessed during stable treatment periods (i.e., the period of SSA dispensings with constant dosage and little variation in injection intervals). RESULTS: Sixty-two octreotide LAR users and 16 lanreotide Autogel users were identified. Stable treatment was observed in 46/62 (74%) octreotide users and 12/16 (75%) lanreotide users. The median (IQR) duration of the first stable phase was 3 (2-9) months for octreotide and 2 (1-3) months for lanreotide. During treatment stability, mean (±SD) injection intervals were 28 (±10) for octreotide and 30 (±6) for lanreotide; however, when patients were categorized into weekly intervals, there were more users on shorter intervals with octreotide than lanreotide (15/46 [33%] vs 2/12 [17%] injected every 3 weeks or more frequently and 9/46 [19%] vs 3/12 [25%] injected every 5 weeks or less frequently respectively). Based on similar dosing but longer injection intervals for lanreotide users, there appeared to be a 5% lower average cost per acromegalic patient treated with lanreotide over octreotide. CONCLUSIONS: The longer injection interval observed with the high dose lanreotide under stable long-acting SSA treatment resulted in reduced costs compared to octreotide. However, the patient numbers of this rare disease and the limited period of treatment stability limit the power to detect differences between preparations.