OBJECTIVES: MDS is a rare hematological disease, that affects the production of blood cells. One of the goals of the treatment is to maintain the blood-cell count in near-normal levels. The means to achieve this are done mainly with the use of hematopoietic- growth factors and transfusions. Our objective was to determine the costs of this supportive treatment under the private payers  perspective in Brazil, for patients with intermediate risk (INT) MDS. METHODS: We adapted the National Comprehensive Cancer Network (NCCN) for INT MDS decision tree to the reality of the Healthcare system in Brazil. Then, we calculated the costs for each branch of the tree, according to the local prices. We also simulated the total costs for a cohort of 100 patients, distributed in the branches according to the expected epidemiology. We assumed an horizon of one year of treatment. RESULTS: The mean cost of SC for MDS was US$45,006/ patient/ year. This value can vary from US$33,368 to US$104,210, according to the patients’ characteristics and types of treatments used. Overall, patients requiring the use of immunotherapy, with anti-tymocyte globulins were associated with the highest costs. Those achieving disease stabilization solely with the use of erythropoietin were associated with the lowest costs. CONCLUSIONS: The SC of SMD is associated with a mean cost of US$45,000/patient/year in Brazil. New treatments have the potential to change this scenario if they can diminish the requirements for the costliest supportive procedures.