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To estimate the cost of chronic pain in Italian general practice from a payer perspective.A retrospective study of two months’ duration.48 General Practitioners (GPs) in Italy recruited 543 patients who attended a consultation during the period January–September 2001. Afterwards, patients were classified in three groups according to drugs’ prescriptions: Group 1 (173 patients not treated with NSAIDs), Group 2 (285 patients treated with non selective NSAIDs only), and Group 3 (85 patients treated with at least one selective NSAID). Considered costs included drugs, diagnostic procedures, laboratory tests, and hospital admissions. GPs were asked to split all costs into two categories: i) costs related to pain; ii) costs related to gastrointestinal (GI) adverse events.Patients of Group 3 were significantly older than the others and had a higher proportion of ostheoarthritis as diagnosis. Differences between mean costs per patient by group (Group 1 € 26.47, Group 2 € 103.67, Group 3 € 139.00) were significant. Costs of Group 3 were higher also when the analysis was limited to GI adverse events (Group 3 € 6.83, Group 2 € 4.42, Group 1 € 1.10).This study is a first attempt to assess costs of chronic pain in Italy. Further studies with a longer time horizon should follow in the future to assess the robustness of results.