Abstract. Opioid analgesics are medicines of choice for management of moderate and severe chronic pain, which is one of the most common symptoms in 70-80% of patients in terminal stages of life. One of the perspective synthetic opioid is Methadone, which is used as a medicine for substitution maintenance therapy in the treatment of opiate dependence and administered as pain reliever. A systematic review of the comparative clinical trials of the use of Methadone and Morphine in palliative patients found that Methadone is an effective, safe alternative opioid which provides adequate analgesia. This confirms that the therapeutic efficacy of Methadone is not lower than of Morphine, so that Methadone can be allowed for use as an alternative medicine. Using a pharmacoeconomic analysis was established a better ratio of “cost-effectiveness” for Methadone unlike Morphine (1.35 vs 17.57), which points at higher economic availability of Methadone.