OBJECTIVES: Recently, MBC-HR+ was found to have a diverse pattern of response to the treatment compared to other MBC. Our aim is to determine the costs of treatment associated with this disease, from the perspective of BPS. METHODS: A large private database of medical claims for chemotherapy (Ch) (Evidencias Database) was searched in order to identify MBC-HR+, that were treated in the last two years (2011-12). We extracted data regarding treatment received, length of the treatment and antropometric data for each MBC-HR+ patient. After, medical literature was performed for studies of MBC-HR+ treatments and the same data was extracted. Based on the combination of real-world (RW) and published data we constructed a decision tree, considering three groups of MBC-HR+, according to the sites of metastasis: bone exclusive (B), Visceral exclusive (V) and bone plus visceral (BV). For each group, we calculated the costs of the treatment plus adverse events, by a micro-costing approach. We simulated a cohort of 100 patients with MBC-HR+ in a decision tree, to obtain the costs for each group and a mean cost/ patient. RESULTS: RW data showed the following distribution of patients: B 38%, V 42%  BV 20%. Lengths of treatment (in months) were B: 25.1 to 30.5; V 16.1; BV 14 to 19.6. Most commonly used treatments were, B – two hormonal lines, fulvestrant and three lines of Ch. V – Four lines of Ch; BV- one hormonal line, fulvestrant, three lines of Ch. Most used Ch drugs were docetaxel, paclitaxel and gemcitabine.  Mean costs/patient/group, considering hormones, Ch, bisphosphonates, hospitalization, infusion, evaluations of the disease, radiation therapy and adverse events were: B- R$ 135,744 (US$ 67,872); V R$ 129,079 (US$64,539) and BV R$ 117,172 (US$58,568).  CONCLUSIONS: MBC-HR+ is associated to a high cost of treatment under the BPS perspective.