OBJECTIVES: Chronic lymphocytic leukemia (CLL) is a slowly progressing but mortal disease that imposes a high economic burden on sickness funds and society. The objective of this study is to analyze and compare the direct and indirect costs of CLL in Germany from the perspective of both sickness funds and society, and to analyze the burden of the disease. METHODS: Using a database of 7.6 million enrolled individuals, we identified 4198 CLL patients in 2007 and 2008. Costs attributable to CLL were estimated using a case-control design, with a control group of 150 individuals randomly drawn by age and sex for each CLL observation. We used GEE and count data models to test for differences in costs and healthcare utilization. RESULTS: The cost attributable to CLL per prevalent case amounts to €4946 from the payer’s perspective, and €7910 from that of society. Inpatient stays and pharmaceutical consumption are the main cost drivers of the disease. The burden of disease in Germany is estimated to be approximately €201 million per year from the sickness fund perspective (€322 million from the societal perspective). CONCLUSIONS: Compared with common diseases such as diabetes or COPD, the economic burden of CLL is considerably lower. However, the cost of treatment per case is about twice as high as for these common diseases, even though treatment is performed in later stages only. Owing to new healthcare technologies, an ageing population, and an increasing incidence, it is likely that the burden of the disease will continue to grow.