This is a cross-sectional, observational study carried out in a tertiary care hospital in South India. Patients undergoing twice weekly maintenance hemodialysis were included in the study. The data pertaining to the pharmacoeconomic- related direct medical and non-medical costs were collected from patient interviews, records, medical bills and other relevant sources.  85 patients were included in the study. RESULTS: The mean age was 53 years with 73.1% males. Majority of them belonged to the middle class as assessed by the Kuppuswamy’s socioeconomic scale with 34% being currently employed. Most (90%) of them were married and 70% had atleast 1 person accompany them to the dialysis centre. Public transport was used as the means of travel to the dialysis centre by 73% of patients with a mean distance of travel of 38 kilometers. All of the currently employed patients had a loss of pay on the dialysis days. Majority (83%) of the patients were on dialysis for more than 2 years. Hemodialysis was not funded by insurance for 31% of the patients. The mean expenditure per month per patient was 20,840 Indian rupees (US$ 309.45) which included 45% spent on hemodialysis and a significant 55% non-hemodialysis related expenses (18% on erythropoietin and intravenous iron therapy, 20% on other medications, 8% on travel, 6% on food consumed during visits to the dialysis centre and 3% on routine monthly laboratory investigations). CONCLUSIONS: The costs related to hemodialysis and loss of wages by patients and their family are significantly high and it is the right time for the governments to provide subsidy on dialysis treatment and medications in developing countries.