OBJECTIVES: To compare early polipectomy based strategy with initial treatment with fluticasone propionate nasal drops (FPND) for the treatment of bilateral nasal polyposis in adults in Poland. METHODS: A decision analytic model was developed to reflect current clinical practice in management of bilateral nasal polyposis in Poland. Early polypectomy, preceded by computed tomography and followed by FPND for four months was compared with initial treatment with FPND. In case of treatment failure of the drug based strategy, patients were treated with systemic corticosteroids and thereafter polypectomy. Data on treatment methods efficacy were derived from literature review. Cost analysis was performed from payer perspective. Sensitivity analysis focused on surgical treatment costs and FPND efficacy. RESULTS: The strategy based on initial treatment with fluticazone propionate nasal drops resulted with treatment cost of PLN 768, while early polypectomy resulted with cost of PLN 1251. When surgery was performed in outpatients settings the mean treatment costs were PLN 586 for initial fluticazone and PLN 751 for early polypectomy. Sensitivity analysis revealed that FPND is less costly therapy unless no computed tomography is performed prior to polypectomy and the cost of surgical procedure falls below PLN 170. CONCLUSIONS: Treatment strategy based on fluticasone propionate nasal drops is effective in bilateral nasal polyposis and results in short-term cost savings.