OBJECTIVES: To assess the management and associated lifetime costs in MM patients as from the diagnosis of unresectable metastatic disease until death. METHODS: A retrospective patient chart review was performed at the Antwerp University Hospital to obtain data on medical consumption related to the management of unresectable metastatic MM (umMM). A complete registry of all MM patients who visited the hospital between 2007 and May 2012 was compiled. Eligible for this retrospective chart review were patients with umMM with sufficient data available and who deceased before May 2012. Data on demographics, disease characteristics and management of umMM were collected. Direct costs were calculated by multiplying each item of resource use with its unit cost (2012, € ) using the Belgian public health care payer’s perspective (PHCP) and patient’s perspective. Average (bootstrap 95%CI) overall costs per patient were calculated. RESULTS: Out of 148 registered MM patients, 29 were eligible and included in this chart review. The median overall survival time in all patients was 6.0 months. 86% (n=25) of patients were treated by systemic treatment(s) of which 24% (n=6) received up to 4 different treatment lines. Dacarbazine was administered in all patients as a single agent or in combination therapy. 4 patients received 1 to 4 cycles of ipilimumab treatment. 53 (43%) of the 123 hospitalizations were for chemotherapy administration. The mean overall cost per patient was €31,637 (bootstrap 95% CI:23,993- 39,891), of which € 30,585 € (95%CI: 23,154-38,784) was reimbursed. The PHCP cost was driven by hospitalization costs and systemic treatments costs both representing 33% of total cost. CONCLUSIONS: Management of umMM result in considerable costs for the PHCP mainly driven by systemic treatment costs and hospitalization costs.  It would be interesting to extend this study in a broader population.