OBJECTIVES: To evaluate the first-year direct medical cost for diagnosis and management of newly diagnosed SA, to identify SA-related resource consumption pattern in public hospitals in the New Territories East Cluster in Hong Kong and in patients with and without procedures, and with comorbidities of hypertension (HTN), diabetes mellitus (DM) and hyperlipidemia. METHODS: A retrospective non-randomized study was conducted including patients documented with new diagnosis of SA in the Clinical Management System during January 2007 to December 2009. Subjects were followed for 1 year after diagnosis. Cost items studied consisted of hospitalization, clinic visits, diagnostic tests, radiological examinations, laboratory tests, therapeutic operations and medications. For statistical analyses, Mann-Whitney Tests were performed to compare medians of costs in patients with and without procedures, and with different comorbidities of HTN, DM and hyperlipidemia. P-value <0.05 was regarded significant. RESULTS: 89 patients were recruited. The mean first-year total direct medical cost of SA per patient was HKD$89,518, with the cost for hospitalization being the most dominant, accounting for 29.2%. Increase in complexity of disease would increase the total from HKD$47,744 for patients without procedures to HKD$115,342 for patients with procedures (p<0.001). For the three comorbidities interested, SA patients co-morbid with hyperlipidemia required more resources for the management, HK$98,295 (p<0.001). CONCLUSIONS: This study revealed the huge expenses incurred by SA in the first year of initial diagnosis on local public healthcare system, which has a significant implication on future resources allocation. Strategies for cost saving and preventive measures should be implemented.