OBJECTIVES: To compare the health care costs 6 months prior to and 6 months after initiation of pregabalin in generalized anxiety disorder (GAD) patients in Sweden. METHODS: This was a retrospective longitudinal database study of GAD patients from the South-West region of Sweden (1.5 million inhabitants). Individual patient data on health care visits (outpatient, inpatient, primary care), costs, mortality and diagnoses were included from year 2000. Data from the Swedish Prescribed Drug Register were included from July 1, 2005 until December 31, 2007. Patients with a GAD (ICD-10 F41.1) diagnosis and who initiated pregabalin treatment in 2006 were included.  Health care utilization was measured six months before and six months after pregabalin initiation. Patients with 2 or more prescriptions of benzodiazepines six months prior to pregabalin initiation were categorized as benzodiazepine patients. Non-parametric statistical tests (Mann-Whitney) were used for the cost and resource use comparisons. RESULTS: A total of 149 patients met the inclusion criteria, of whom 99 used benzodiazepines prior to pregabalin treatment. The number of in-patient (p<0.05) and primary care (p<0.05) visits significantly decreased in the 6-month period following pregabalin initiation. There was also a statistically significant reduction (p=0.0004) in overall health care costs from SEK 71,000 (€7,408) to SEK 45,000 (€4,695). Among the benzodiazepine users (n=99), the number of in-patient visits (p=0.0213), days in hospital (p=0.0026) and primary care visits (p=0.0121) were all statistically significantly reduced following pregabalin initiation. The reduction in total cost (from SEK 79,000 to SEK 43,000; €8,243 to €4,486) among the users of benzodiazepines was also statistically significant (p=0.0001). The decrease in total cost, in all patients as well as benzodiazepine treated, was to a large extent explained by the decrease in in-patient costs. CONCLUSIONS: Initiating treatment with pregabalin in GAD patients significantly reduced healthcare utilization and costs during the following 6 months.