OBJECTIVES: Patients with BMs from advanced cancer experience SREs (radiation/surgery to bone, pathologic fracture or spinal cord compression). Limited data exist on the financial burden of SREs. HRU data will support healthcare resource planning and the assessment of new products that prevent/delay these events. METHODS: Eligible patients with BMs from breast/lung/prostate cancer or multiple myeloma were enrolled in centres in Austria, Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland. HRU extracted from patient charts included inpatient stays, outpatient visits, day care visits, emergency room visits, procedures, etc. We present HRU data for Austria, Czech Republic, Poland, Sweden and Switzerland (collected retrospectively from both 3.5 months prior to the SRE and 3 months after the SRE). RESULTS: A total of 658 eligible patients with at least one SRE were enrolled across five countries (36%, 13%, 27% and 25% had breast, lung and prostate cancer and multiple myeloma, respectively). Across all tumour and SRE types, mean increase from baseline in number of inpatient stays per SRE for Austria, Czech Republic, Poland, Sweden and Switzerland, respectively, were 1.0(95%CI:0.7-1.3), 0.8(95%CI:0.6-1.0), 0.9(95%CI:0.7-1.1), 0.8(95%CI:0.6-0.9) and 0.9(95%CI:0.7-1.1), with a mean increase in total length of stays per SRE of 16.4(95%CI:13.1-19.8), 11.4(95%CI:8.0-14.8), 10.9(95%CI:8.8-13.0), 13.4(95%CI:9.3- 17.4) and 17.2(95%CI:13.6-20.7) days, respectively. For the same countries, the mean increase in number of outpatient visits per SRE were 3.8(95%CI:2.7-4.9), 4.7(95%CI:3.5-6.0), 1.1(95%CI:0.7-1.5), 1.3(95%CI:0.7-1.8) and 5.2(95%CI:4.0-6.5). Mean increase in number of procedures per SRE were 10.9(95%CI:9.5-12.2), 6.9(95%CI:5.6-8.2), 4.4(95%CI:3.7-5.0), 4.7(95%CI:3.9-5.6) and 10.1(95%CI:8.8-11.4). Data by SRE type show considerable HRU variation. CONCLUSIONS: Data indicate that SREs may result in a mean increase of 0.8–1.0 inpatient stays with a mean total duration of 10.9–17.2 days. SREs are also linked to numerous outpatient visits and procedures. Thus, a further reduction in the number of SREs by new bone-targeted agents should reduce the financial burden on European health care systems.