OBJECTIVES::  In Brazil, the private healthcare system covers more than 47 million people, having a larger market-size than several countries. In oncology, the increasing costs of new drugs represent an important barrier in health policy planning and decision-making on health technology assessment (HTA), which can be assisted by real world data. Therefore, the aim of this study was to describe burden of cancer treatment in the private healthcare setting in São Paulo state. METHODS::  We reviewed all outpatient cancer treatment-related procedures in D-TISS database from July 2015 to June 2016. Costs of procedures were calculated according to the Brazilian Hierarchical Classification of Medical Procedures, 6th Edition. Oral anticancer therapy was not accounted for costs analysis due to absence of medical honoraria. All costs are represented in USD and BRL (1USD=3.1242BRL). RESULTS::  We identified 157,025 cancer treatment procedures, in 20,868 patients in the aforementioned period. Most of the patients were women (62.0%) aged 19 to 60 years (42.5%). The most common procedures were oncology treatment planning and first treatment day (52.1%), subsequent days of treatment (33.0%) and oral anticancer therapy (9.8%). Patients had median 5 (IQR 1-3:2-9) cancer-treatment procedures of in one year. Total costs regarding cancer treatment totalized 23,393,260.4 BRL/ 7,487,760.2USD in one year in São Paulo State and had the median value of 774.5BRL (IQR 1-3: 260.7- 1660.9)/247.9USD (IQR 1-3:83.4-531.6) per treated patient and 1.32BRL /0.42USD per health plan beneficiaries. CONCLUSIONS::  New high-cost cancer treatments may hamper policy making in healthcare in Brazil, especially in the private setting. Our analysis demonstrate the high economic burden of cancer in the private healthcare setting treatment, exclusively considering the procedures cancer treatment-related. This economic burden would be even higher if considering all procedures.