OBJECTIVES: To estimate the direct costs of HCV management for genotype 1 patients throughout their lifetime based on the natural history of the disease from payer perspective in Colombia METHODS: Direct costs were estimated from a payer perspective by using a micro-costing approach of all relevant resources used to manage patients with HCV genotype 1 since the diagnosis for a lifetime perspective. Resources and clinical practice were identified, measured and valued for nine health states. Resource use and clinical patterns were validated with a panel of experts in managing HCV patients by applying a comprehensive survey. Each of the resources was valued based on standard national public lists of fees in Colombian pesos. Total costs for each of the health states of the disease were calculated for a one year time horizon RESULTS: Direct cost were presented in US Dollars using the average year to date exchange rate (USD 1 = COP 1,974). Estimated average direct cost for each health state per year: non diagnostic HCV (USD 512), chronic HCV F0-F3 (USD 1,440), compensated cirrhosis (USD 976), decompensated cirrhosis (USD 10,782), hepatocellular carcinoma (USD 10,263), liver transplantation (USD 28,883), post-transplant (USD 1,933), monitoring drug therapy for HCV and the management of adverse events (USD 1,020), death (USD 15,538). CONCLUSIONS: Chronic HCV infection represents an important economic and humanistic burden for health systems in the world. This micro-costing study provides valuable information for further economic cost of illness analysis from the Colombian payers setting. It also reflects severity and economic impact of HCV related health states.