OBJECTIVES: Cancers have incurred significant financial burden to both the patients, their families and society. Reliable estimates of the burden of cancer will therefore help to guide resource allocation. This study thus aimed to conduct cost analysis on anti-cancer medications for top ten high-expenditure cancers in Taiwan. METHODS: The data used for this population-based study were retrieved from the 2003-2013 Taiwan’s Longitudinal Health Insurance Database (LHID). Patients with newly diagnosed cancers were identified, and their total direct medical costs, as well as sum of all drug costs and sum of anti-cancer drugs costs [defined by WHO’s Anatomical Therapeutic Chemical (ATC) classification system: code “L01”] were calculated. Expenditures per patient per month (PPPM) and first-year drug expenditures per patient were calculated. RESULTS: A total of 17,188 patients were analyzed in this study. The most prevalent cancers were colorectal cancer, followed by female breast cancer and liver cancer. The PPPM of total direct medical costs was highest in leukemia (USD 2.3 thousands) and esophageal cancer (USD 2.1 thousands), while were lowest in female breast cancer (USD 587) and prostate cancer (USD 531). However, the proportion of anti-cancer drug cost was higher in lung cancer and female breast cancer (over 10%), in contrast to lower proportion in liver cancer, oral cancer, gastric cancer, and esophageal cancer (less than 1%). The highest sum of all drug costs in first-year per patient was seen in leukemia, followed by non-Hodgkin lymphoma and lung cancer, and the lowest was seen in liver cancer. CONCLUSIONS: This study demonstrates the significant burden of anti-cancer treatment in each cancer. In addition, the proportion of drug costs shows a large variety in different cancers. These differences are good references to optimize the allocation of national health resources.