OBJECTIVES This burden of illness study was conducted to assess the 12-month resource utilization and healthcare costs, along with the major drivers of those costs, associated with an incident diagnosis of prostate cancer (PC). METHODS An analysis of incident PC patients identified using a claims database, was performed, for 2005, 2006, and 2007. PC patients and the age and gender matched comparator group (1:4) for each year, were required to have continuous enrollment in a plan and no prostate cancer diagnoses during the 18 months prior to the first diagnosis of prostate cancer in the year. The PC and comparison groups were each described in terms of their health care service use and health care costs, which were compared, using nonparametric Wilcoxon rank-sum tests, with mean values reported here for 2007. RESULTS There were 21,520 men diagnosed with PC in 2007, in this database, and we selected 86,080 controls. The mean healthcare cost for the men diagnosed with PC was $19,979 vs. $7,105 for controls; p<0.001. The primary drivers for this nearly triple cost difference between the two groups were: hospitalizations ($6,292 vs. $2,375; p<0.001); radiology tests ($3,014 vs. $348; p<0.001); prescription drugs ($2,293 vs. $1,439; p<0.001); and laboratory tests ($880 vs. $203; p<0.001). Resource utilization over the 12-month period showed that the men with PC, when compared to the control group, had a significantly greater (p<0.001) mean number of hospitalizations (0.4 vs. 0.2; p<0.001); radiology tests (10 vs. 2; p<0.001); prescription drugs (22 vs. 16; p<0.001); and laboratory tests (18 vs. 8; p<0.001). CONCLUSIONS The significantly higher 12-month resource utilization and health care costs noted in men diagnosed with PC, compared to age and gender matched controls, are primarily driven by an increased need for hospitalizations, radiology tests, prescription drugs, and laboratory tests.