OBJECTIVES:  Pasireotide, a second-generation somatostatin analogue (SSA) was investigated in a clinical trial (PAOLA) for treating acromegaly patients not controlled on 1^stgeneration SSAs (octreotide/lanreotide). Despite superior efficacy, patients with pasireotide reported higher rate of drug-induced hyperglycemia than octreotide/lanreotide patients. Many concerns on rate of hyperglycemia were raised; however, according to Gadelha et al., pasireotide- induced hyperglycemia seemed to be manageable with currently available anti-diabetic medications (ADMs). The aim of this study is to assess economic burden of pasireotide-induced hyperglycemia in PAOLA population. METHODS:  A cost model (MS Excel 2010, v14.0.) was developed to estimate average weighted costs of hyperglycemia management from UK NHS perspective. Resource use was separated into ADMs, self-monitoring of blood glucose, physician visit, and HbA1c laboratory monitoring. Data was obtained from British National Formulary 64, NHS reference costs, and PAOLA. RESULTS: : Average yearly cost per patient (AYCPP) of ADMs for pasireotide group was £154.83 versus £134.41 for control group. AYCPP for overall resource utilization including ADMs was £777.45 for pasireotide group versus £756.92 for control group. Among the pasireotide-treated patients diabetic (DM) at baseline and experiencing hyperglycemia post-basline (n=36), 10 patients with no ADMs at baseline had new ADMs added; the associated AYCPP was £99.04. For remaining patients having ADM use at baseline and experiencing hyperglycemic event post-baseline, the AYCPP of switching to new ADMs was £48.19. Incremental costs of ADM utilization from baseline to end of study for treatment and control arms were £48.98 and £85.78 respectively. CONCLUSIONS: Overall, cost difference of hyperglycemia management in patients treated with pasireotide versus first generation SSAs was minimal. Additionally, pasireotide patients diabetic at baseline and receiving new or added ADMs from baseline for hyperglycemic events were estimated to spend minimal healthcare budget. This cost model will be useful to inform payers decisions related to resource allocation for hyperglycemia management in acromegaly treatment.