OBJECTIVES: The national estimate of total cost of illness for pain as published by the National Institute of Health in Fiscal year 2000 is 79 billion dollars whereby 45 billion dollars were contributed by direct costs and 34 billion dollars by indirect costs. Due to the prevalence and excessive cost of pain in the United States (Gatchel R.J., 2001) it is important to estimate current economic burden of pain on the society. This study aims to estimate and compare direct costs and wages lost due to missed workdays (WLMW) of pain with three of the five most costly conditions: angina, myocardial infarction (MI), and hypertension. METHODS: The self-administered questionnaire and priority conditions supplement from 2000 Medical Expenditure Panel Survey were used to extract 4 groups of patients (pain, angina, MI, and hypertension). A matched sample size of 399 patients per group was identified. The costs were annualized and are reported in dollars. Direct costs included physician, non-physician, outpatient, inpatient, emergency room, medical supplies, and home health care expenses. The WLMW were computed using the following formula: [(Workdays lost due to illness or stay in bed) x (Hourly wages) x (8)]. The analyses were undertaken using SAS v.8.2. and Microsoft Excel 2000. RESULTS: The results are limited to the 2000 MEPS database. Direct cost per pain patient was $3,173 as compared to $9,646 for MI, $9,504 for angina, and $5,204 for hypertension. The WLMW per pain patient was $210 as compared to $318 for hypertension, $260 for MI, and $164 for angina. CONCLUSIONS: Pain is a costly condition. In terms of direct costs, pain was not as costly as MI or angina. The WLMW per pain patient was greater than angina by $46.