OBJECTIVES: Wet macular degeneration associated with age (wet-AMD) is the leading cause of legal blindness in Spain in people over 55. The aim of this study is to determine health care resource utilization and mean costs per patient with wet-AMD in 2009. METHODS: A micro-costing analyses was performed to estimate direct medical costs of patients with wet-AMD. Patient level data was obtained from different public hospitals in Spain and ophthalmologists were surveyed with a semi-structured questionnaire to obtain treatment patterns. Inpatient costs were considered from the perspective of the public health care system. Treatments under study were pegaptanib, verteporfin, ramibizumab and bavacizumab. Although bevacizumab in Spain is not approved for wet-AMD, it was used off-label in the hospital. Direct medical costs considered were drug costs, administration cost, doctors’ visits, nurse time, ophthalmologist time, anaesthetics, ambulant hospital care, external consultation, surgery and treatment of adverse effects. All costs are referred to 2009.  RESULTS: Mean cost per patient treated with wet-AMD represented the following cost for the public health care system: €7290 for pegaptanib, €5810€ for verteporfin, €8650 for ramibizumab and €3110 for bevacizumab. We also estimated that in Spain 180,000 people over 50 years have wet-AMD in 2009. CONCLUSIONS: Pharmacological treatments for wet-AMD are photo dynamic therapy with verteporfin, pegaptanib, verteporfin and ramibizumab, with the last one having the highest medical costs. The aging of the population and development of new drugs will probably increase the future economic impact of AMD, which remains a major health care burden.