OBJECTIVES: To estimate the direct cost of Del5q MDS from the perspective of the public healthcare system in Mexico METHODS: We evaluated the amount of resources utilized by patients with Del5q MDS from an expert panel of eight hematologist through the Delphi technique. Consensus was reached after two expert panel rounds and patterns of use were analyzed statistically. Unit costs of resources were extracted from institutional catalogues and annual cost estimations were performed for different health states. All values were expressed in US dollars of 2015 RESULTS: From the consensus of panel experts we found that management of patients with Del5q MDS at Mexican public healthcare institutions consisted of best supportive care with red blood cell (RBC) transfusions and erythropoiesis-stimulating agents, and since these patients are RBC-transfusion dependent, they receive 33 units of RBC per year resulting in a cost of US$5,265.60. Iron overload is the main complication of transfusion dependency resulting in an annual cost of US$1,782.11 attributable to congestive heart failure. Other resources used to the treatment of the disease are drugs, labs, and visits that contribute to the total annual cost of US$30,647.78 per patient CONCLUSIONS: MDS patients with 5q deletion impose a high economic burden to the public healthcare system in Mexico, although the incidence is lower than other hematological malignancies