OBJECTIVES: This study evaluated the cost-effectiveness of ITS versus current POPM choices in Greece from the hospital perspective. METHODS: Two hundred, forty-nine surgeons and anesthesiologists were interviewed to derive the most frequent treatment sequences for POPM for patients experiencing moderate to severe post-surgical pain. These were: a) 2 days intravenously administrated (IV) opioids, 2 days IV non opioids, 1 day oral non-opioids; b) 2 days intramuscularly administrated (IM) opioids, 2 days IV non-opioids, 1 day oral non-opioids; c) 2 days epidural, 3 days oral non-opioids. A decision analytic model was developed to estimate costs and effectiveness of each these sequential treatment arms, from surgery to discharge, compared with 2 days of ITS followed by 3 days of oral non-opioids. Effectiveness data were obtained from ITS trials and published literature. The resource utilisation was defined by the same physician interviews and a Delphi Panel of 40 Greek physicians. Costs included pain medication and cost of POPM-related complications not covered by or exceeding the daily reimbursed amount to the hospital, the hotel costs and finally staff time estimated during four European Delphi Panels. The complications' cost was estimated by the Greek Delphi panel. Sensitivity analyses (±30%) were performed on the cost of complications and staff time estimations. RESULTS: The probability of a successful treatment (adequate pain control and no complications) was 76% for ITS, 49% for the first two treatment sequencies and 72% for the third. Total cost per patient was 677-717€ for ITS and €717, €704, €770 for the three sequences respectively. ITS was associated with reduced staff time and fewer complications. The model was robust with low-moderate sensitivity (±€10 change of base results). CONCLUSION: The treatment sequence of ITS dominated the currently practiced POPM treatments in Greece indicating that ITS cost was offset by savings resulting from reduced staff time and fewer complications.