OBJECTIVES: To compare cost-effectiveness of detoxification and maintenance treatment with buprenorphine/naloxone combination in Turkey. METHODS: We adapted a micro-simulation decision model to the real-life conditions in Turkey using locally-specific data for treatment costs of buprenorphine/naloxone combination with the average dose of treatment set at 8.6 mg/day (range 2-16 mg/day). Direct costs of detoxification consisted of the costs of a 28-day in-patient stay, while direct costs of maintenance treatment included costs of three psychiatrist visits per month during the first three months, two psychiatrist visits during the next three months (Month 4-Month 6), and a single psychiatrist visit from Month 7 to Month 12; all psychiatrist visits were also accruing the costs of urine toxicology tests, with the first visit also including costs of biochemical check-up, and all subsequent visits including also costs of the group therapy. Direct costs of treatment of infectious diseases were based on COBRA (Cost-Benefit and Risk Appraisal of Substitution Treatment in Routine) study and adjusted to conditions of the local jurisdiction. Main outcome measures were costs, gains in quality adjusted life years (QALYs), and incremental cost-effectiveness ratios (ICERs). RESULTS: Our model has shown that under base case scenario maintenance treatment with buprenorphine/naloxone dominated detoxification with buprenorphine/naloxone by saving 281 TL (cca €86) and gaining 0.140 QALY per patient over one year. With low dose of treatment (2 mg) the dominance of maintenance treatment over detoxification was retained, while at the high dose, resulting ICER amounted to 5,300 TL/QALY (cca. €1,615/QALY). Modification of other modeling parameters confirmed our findings. CONCLUSIONS: Results of our study suggest that in Turkey maintenance treatment with buprenorphine/naloxone combination is at least cost-effective (and may be even cost-saving) versus detoxification with buprenorphine/naloxone combination. These pharmacoeconomic results are particularly important for those patients who have the need to be less stigmatized when accessing care.