OBJECTIVES: The cost of cancer medications is continually increasing, mostly due to the introduction of targeted monoclonal antibodies. Panama, with a population of 3,867,535 and a GDP (2014) of $46,212 million, has a cancer incidence of 143.60/100,000 inhabitants that has been continuously increasing during the last decade. Prostate, cervix and breast cancer are the most frequent diagnoses. The objective is to calculate the antineoplastic drug expenditure (ANDE) in Panama, between 2012 and 2014. METHODS: Drug expenditure databases from the National Oncologic Institute and Social Security were reviewed. All medications cataloged as antineoplastic and immunomodulatory were considered ANDE and included in the analysis. Costs were not adjusted for inflation and are presented in nominal terms. RESULTS: Although total medication spending diminished from 2012 to 2014, ANDE increased from 30.29% ($65,444,381.40) to 35.95% ($76,327,361.37), respectively. In a stratified analysis, variations in the increment of ANDE were observed among institutions. In the Oncologic Institute, ANDE increased 30.31%: from $24,619,703.70 in 2012 to $35,329,894.15 in 2014, while in the Social Security, expenses remained almost the same, with an increment of 0.42%: from $40,824,677.70 in 2012 to $40,997,467.22 in 2014). The medications that accounted for the greater percentage of ANDE were irinotecan (9.19%), trastuzumab (8.65%) and bevanizumab (7.26%) in 2012, rituximab (8.97%), trastuzumab (8.76%) and brevanizumab (7.31%) in 2013 and rituximab (10.44%), imatinib (8.73%) and brevanizumab (6.86%) in 2014. CONCLUSIONS: Antineoplastic drug expenditure has increasingly growing during the last years and constitutes the group of medication where the Panamanian Health System is investing the most. The increment in the incidence of cancer diagnosis and the utilization of monoclonal antibodies that usually are associated with elevated costs seem to be an explanatory factor. A comprehensive analysis including number of diagnosis and the use of treatment by type of cancer becomes paramount.