OBJECTIVES: To analyze the cost of care in oncology inpatients in Brazilian private hospitals and their spending on medicine (chemotherapy and palliative care). METHODS: We selected patients who consume antineoplastic medicines in Orizon database (16 million lifes) within a 12-month period and analyzed their medical bills, appointments and hospitalizations (direct costs) and also medicines for palliative treatment. RESULTS: We identified 1244 patients who consume an annual average of R$ 6,342.51 in outpatient use of anticancer drugs per patient and their medical bills US$30,320.78 in expenses with a mean hospital stay of 4.60 days with 4, 48 consultations per patient to the cost of R$210.56 and the cost of medicines for palliation of R$6,277.16 (regulators of bone metabolism, corticosteroids, antidepressants, anti-inflammatories, diuretics, antiemetics, anticonvulsants, analgesics, vitamins and antispasmodics) CONCLUSIONS: The direct costs of cancer patients is not restricted only hospital infusions and their admissions, but also outpatient expenditures such as oral medications and palliative treatments.