OBJECTIVES: To evaluate direct treatment cost associated with pegylated liposomal doxorubicin hydrochloride (PLD) and topotecan used as second line therapies for ovarian cancer in Poland. METHODS: The literature review showed topotecan and PLD have similar efficacy in platinum-refractory or platinum resistant advanced ovarian cancer but different adverse events profile. The cost-minimization analysis was performed from the payer's perspective. Only direct medical costs (i.e. drug acquisition costs, drug administration costs and managing adverse events costs) were included. Based on epidemiological data budgetary impact of PLD treatment in Poland was estimated. RESULTS: The acquisition and drug administration costs were estimated at 12,448€ and 6,935€ for PLD and topotecan, while cost of managing adverse events at 134€ and 1234€ for PLD and topotekan, respectively. The total cost per patient summed up to 12,882€ for PLD and 8,169€ for topotecan. 38% reduction in acquisition cost of PLD would balance topotecan associated costs. Epidemiological data indicated 985 platinum-resistant or platinum-refractory ovarian cancer patients in Poland were eligible annually for treatment with PLD, thus additional cost could be estimated at 4.64 mln €. CONCLUSION: PLD represents attractive treatment strategy in second line therapy of platinum-resistant or platinum-refractory ovarian cancer, although acquisition cost reduction is necessary were compared to topotecan in Polish settings.