OBJECTIVES::  In Islamic Republic of Iran, due to increasing incidence of cancer and its high treatment costs, health sector policy makers tried to design and implement a supportive healthcare plan. Therefor Iran `s healthcare reform has been implemented since May, 2014. One of the most important objectives of this reform is to reduce hospitalized patients` out of pocket (OOP). This study aims to evaluate this reform performance in one of the pilot referral centers which is Imam Khomeini governmental hospital, Sari, Mazandaran. METHODS:: In this retrospective study, study population included all cancer patients (7 cancer groups) who were admitted in this referral center, in the first six-month of 2013 and 2014 as a control and case representative, respectively. Patients` costs were analyzed and interpreted in various subgroups. Data analysis was done by Excel 2013, SPSS 21<sup>st</sup> version software RESULTS:: Around 778 and 707 cases were enrolled to study for 2013 and 2014, respectively. Patients' OOP in terms of total treatment cost was reduced significantly in 2014 after healthcare reform implementation which was approximately 12.7% and 3.02% in 2013 and 2014, respectively. On average 11.5% health subsidized was obtained for each patient through health care reform. CONCLUSIONS:: In comparison with other developing countries, cancer patients` OOP is still a huge amount in Iran. Regarding to these patients' high treatment costs, paying attention to prevention is useful to reduce treatment expenditures. Screening programs are needed to be covered in health system reform plan. As a result, to reduce patients` costs, there is still room for revision in the field of healthcare. According to Ministry of Labor’s basic wage announcement, this patients OOP includes more than half of their annual income. Future research is needed to evaluate whether these amount of OOP is catastrophic or not.