OBJECTIVES: Most pharmacoeconomic studies concentrate mainly on drug costs and, possibly, some additional costs encountered in drug delivery when analysing overall hospital costs. Examination costs are mainly ignored or, at best, estimated crudely. A flat rate is usually applied when calculating total therapy costs in hospitals. METHODS: In this study, the total therapy costs of five in house non surgical ENT treatments (30 patients in each group) were calculated, with particular attention to accurate personell costing. Drug costs and examination costs were examined independently. RESULTS: The total therapy costs varied from 816 $ to 1562 $. Daily costs varied from 170 $ to 186 $. Both examination costs and drug costs were noted to amount to 25 - 28 % of the total therapy costs, but individual treatment analysis showed wide variations in their relative contributions. For instance in complicated otitis media examination costs amounted 14.7 % as compared to drug costs of 11.4 %. In contrast, in the treatment of sudden deafness, medication costs accounted for 2.5 % of overall costs versus 24.6 % on examination costs. CONCLUSIONS: Physicians, with cost responsibilities should be aware of the differing contributions to overall costs from drug and examination costs. In detailed analysis, the relative contributions from drug and examination costs can vary widely but in our current study, the overall contribution from these two categories was quite similar. Physicians should be aware of the cost structure in different therapies so that advantage may be taken of potential cost savings.