OBJECTIVES: To assess the cost of monoclonal antibodies in an Athens/Greece tertiary hospital in a seven year cost comparison analysis and to compare results to other in-patent drug categories. METHODS: In this study (2008-2014) monoclonal antibodies (MAbs) consumption in Evaggelismos hospital (931-beds) was assessed. MAbs consumption/cost in hematology, oncology, rheumatology, gastroenterology, ophthalmology and neurology departments was especially studied. The pharmacoeconomic evaluation was performed using a direct cost comparison analysis, in which MAbs cost is compared (2011-2014) to total drug cost per department, total in-patent drug cost, in-patent antibiotics cost and anti-HIV drug cost. The cost saving of Central Cytostatic Drug Preparation Unit operation for the year 2014 was especially studied. The analysis was performed in Euros (€) and drug cost was based on average hospital prices in Greece (official price lists). RESULTS: Data analysis revealed that MAbs relative cost showed an augmentative trend throughout the study period (from 12.6%, 2008 to 13.45%, 2014). MAbs cost for all studied clinics, with the exception of ophthalmology and hematology departments, showed minor decline. In-patent antibiotics and anti-HIV drugs represented a substantial and ongoing category of cost burden prescribed drugs (from 6.18%, 2011 to 9.98%, 2014 and from 13.04%, 2011 to 21.44%, 2014 respectively). CONCLUSIONS: From 2008 to 2012, though a substantial reduce of hospital pharmaceutical expenditure was obtained, due to memorandum obligations, an increase in MAbs consumption was detected (from 12.6% to 13.45%of total drug cost).The average hospital prices for all drugs were reduced for the same period. The total cost saving is mainly due both to generics and off-patent drugs use and drugs' price negotiations supported with an obligated by the Ministry of Health 5% and 6.5 % rebate for in-patent drugs.