OBJECTIVES To perform a complete economic evaluation type using oxycodone (Endocodil XR ®) versus morphine, buprenorphine (transdermal patches) and fentanyl (transdermal patches) on moderate to severe pain secondary to cancer type in Mexico, from the point of view of public health. METHODS A cost-effectiveness analysis was made, a decision tree model was developed to simulate the costs and benefits of health outcomes of each opioid analgesic, the probabilities were obtained through a systematic review of the literature. The model has 13 cycles of 28 days under a time horizon of 364 days, the main measure of effectiveness was determined as days without severe adverse events and pain controlled, only measured direct medical costs and the ratio was obtained incremental cost-effectiveness, further a deterministic sensitivity analysis, probabilistic sensitivity analysis and budget impact was performed RESULTS The results demonstrate that oxycodone (Endocodil XR ®) is a dominant option respect to Buprenorphine (PT), fentanyl (PT),  the results showed 309 days without severe adverse events and controlled pain compared to 219 and 255 respectively Oxycodone had a cost of $ 57,702.34 under $ 58,254.43 and 129,906.49 costing of their comparators respectively, compared to morphine oxycodone is more effective but more expensive ,it had an ICER of $ 202.05, sensitivity analysis and budget impact showed that oxycodone remains an option cost-saving.  CONCLUSIONS The results demonstrate that oxycodone (Endocodil XR ®) is a cost-effective option for the treatment of patients with pain of moderate to severe secondary to cancer in Mexico, it is an option that effectively combines price and fails to meet the necessary standards for palliative care and pain management.