OBJECTIVES: The aim of this study was to assess basal cell carcinoma (BCC) prevalence in real practice, and to calculate the related healthcare resources consumption METHODS: An observational retrospective cohort analysis based on administrative databases of three Italian Local Health Units was conducted. Beneficiaries who have been hospitalised for BCC (ICD-9 code 173) or with a histological diagnosis (ICD-O M8090/3-8093/3) from January 1st, 2009 to December 31^st, 2013 - index date - were included. Patients were characterised back to Jan 2009, and followed up till the end of the observation period (Dec 2013) to assess healthcare resource consumption RESULTS: According to preliminary findings on around 550’000 beneficiaries, BCC prevalence through discharge diagnosis was around 6 cases every 10.000 patients/year; considering also pathological anatomy database, 10 cases of BCC every 10.000 patients/year were reported. Advanced patients (aBCC) were reported to be around 4%, most of them defined according to the following criteria: two surgical excisions on the same side and at least one subsequent procedure (surgery, radiotherapy, photodynamic therapy or imiquimod), 0,3% of enrolled patients had metastasis.During follow-up, ambulatory surgery was performed in 63.5% of advanced patients, around 1.6% underwent radiotherapy and 38.1% of them had at least one hospital admission; imiquimod was prescribed in 11.1% of patients. Yearly aBCC patients resource expenditure was around 404€ for hospitalisations - index costs excluded - 32€ for ambulatory care and 77€ for drugs (anti-inflammatories, antibiotics and topic drugs; 16€ for imiquimod). CONCLUSIONS: As BCC patients are reported to have a low recurrence of hospitalisations, discharge-based analysis would underestimate real prevalence. With pathological anatomy database, this study estimated 0.4 advanced BCC cases/10’000 beneficiaries/year. Healthcare consumption in this sub-population was driven by hospitalisations and ambulatory costs due to surgical excision