OBJECTIVES: Approximately 3% of the global population is infected with the hepatitis C virus. 20% of the patients will develop cirrhosis within 20 years of infection, and these patients have a 1% to 5% risk per year of developing hepatocellular carcinoma (HCC). Standard treatment for hepatitis C is pegylated interferon combined with ribavirin. The objective of this study was to obtain an understanding of the resource utilisation and costs associated with chronic hepatitis C in Sweden. METHODS: A literature review was conducted to identify resource utilisation and costs of chronic hepatitis C in Sweden. The MEDLINE, EMBASE, NHS EED and Cochrane CCTR databases were searched. To validate the results of the literature review and fill gaps in the evidence base, interviews were conducted with eight clinicians and one nurse specialised in the areas of infection, gastroenterology or transplantation medicine. The Skåne price list was primarily used to obtain the unit costs. RESULTS: Twelve publications were relevant for inclusion in the review. There was a lack of resource utilisation data for certain disease stages, primarily decompensated cirrhosis and HCC, and for updated unit costs, in these publications. Also, no studies reported indirect costs associated with chronic hepatitis C in Sweden. The pooled data from the literature review and the interviews indicated a direct cost per year of EUR 300 for mild disease, EUR 400 for moderate disease, EUR 900 for compensated cirrhosis, EUR 13,000 for decompensated cirrhosis, EUR 20,000 for HCC and EUR 120,000 for liver transplantation (including one-year follow up).  CONCLUSIONS:  Chronic hepatitis C is associated with high rates of health care utilisation. The driver of the direct medical costs is the management of long-term consequences including cirrhosis, HCC and liver transplantation. More efficient therapies with higher cure rates could potentially result in long-term cost savings by reducing severe complications.