OBJECTIVES: Retina disease (RD) is a leading cause of blindness in Europe with significant clinical and economic consequences. The research objective was to assess the direct health care resource use of patients receiving regular intravitreal injections (rIVI) to treat RD in France, Spain and the United Kingdom (UK). METHODS: Three focus group sessions were performed with at least 6 retina specialists who treated RD patients with rIVIs (defined as IVIs every 4 to 6 weeks). A specific questionnaire assessed resource use including medical visits, diagnostic/monitoring tests and procedures, drugs administered, IVI adverse event treatment, surgery and transport. Costs were quantified using official and bibliographical sources from each national health care system perspective over a one-year time horizon. All costs are expressed in 2010 euros and pound sterling. RESULTS: The annual total direct health care cost per patient treated with rIVI was €14,725 in France, €10,027 in Spain and £9,647 to £13,759 in the UK (depending on the setting of care: outpatient or day case). In all countries, pharmacological costs accounted for the largest proportion of overall costs (50-80%). Ranibizumab was the most used drug except some countries that reported off-label use of bevacizumab. Non-pharmacological costs, including follow-up visits, tests and administration costs, were €2353, €2918 and £3000-£9096 in France, Spain and the UK, respectively. CONCLUSIONS: Treatment with rIVIs is costly to health care systems. While drug costs account for a large portion of costs, required monitoring is a key cost driver and affects health care systems' capacity to treat RD patients. Any strategy to reduce the number of rIVIs per year would assist in reducing the burden on health care systems. Furthermore, to assess the full cost of treatment, a study assessing direct cost to patients and caregivers and indirect cost is also needed.