OBJECTIVES: A randomized clinical study compare effects of pre-operative eicosapentaenoic acid enriched oral nutritional supplement (EPA-ONS) along with 5-weeks radio-chemotherapy to 5-weeks radio-chemotherapy only on survival and quality of life and safety had been completed and the results were published elsewhere. This abstract aimed evaluate cost effectiveness of 5-week EPA ONS usage compared to no nutritional supplement in terms of survival METHODS: A total 80 colorectal carcinoma patients had been randomized to 5-week radio-chemotherapy (FUFA+EBRT)+EPA ONS (2 package per day) or radio-chemotherapy (FUFA+EBRT) only equally by stratifying age, gender, nutritional status and radiotherapy method. In study time horizon, survival was evaluated by Kaplan Maier estimator and exponential parametric regression model (best fitting model based on AIC-BIC) was used to extrapolate 10-year survival. Since patients’ characteristics, treatment modalities and other procedures were reported to be similar among groups, only cost of EPA ONS was taken into cost-analysis which is prepared from perspective of reimbursement institute in Turkey RESULTS: Mean (95% confidence interval) survival time was 6.8(6.3-7.3) and 5.5(4.6-6.4) years in EPA-ONS + radio-chemotherapy and radio-chemotherapy only groups, respectively. Five week EPA-ONS costs 224.6 USD/per patient. Incremental cost effectiveness ratio (ICER) for in study period was 234.4 USD per life-year gained; when 10-year survival model was used ICER was 97.5 USD per life-year gained. CONCLUSIONS: Survival analysis revealed that preoperative EPA-ONS usage along with radio-chemotherapy prolonged overall survival. EPA-ONS appears to be a cost-effective concomitant treatment of radio-chemotherapy in patient with colorectal carcinoma.