OBJECTIVES: To investigate the financial burden of osteoporosis, breast cancer, and cardiovascular disease among women age 50 to 64 years in terms of the direct health care and indirect work-loss costs to an employer. METHODS: Administrative medical and disability claims data from seven large employers (n>600,000) were analyzed between 1998 and 2000. Patients were identified as female beneficiaries, age 50 to 64 years, who were enrolled in a managed indemnity health plan. Treatment samples were defined using ICD-9 codes to identify principal diagnoses for each of the three study conditions and then compared to a random sample of women, age 50 to 64 years. RESULTS: For the year 2000, osteoporosis patients had direct medical care costs that were $2277 greater than those for the random sample ($4543 versus $2266, P<0.05). For breast cancer, the difference was $12,379 (P<0.05), with hospital outpatient costs accounting for the largest share of total costs (43%). For cardiovascular disease the difference was $12,814 (P<0.05), with hospital inpatient costs accounting for the largest share of total costs (48%). The average number of medical claims per patient was 18.6 for the random sample, compared to 38.4 for osteoporosis patients, 76.0 for breast cancer patients, and 67.0 for cardiovascular patients (P<0.05). Ongoing research will control for demographic characteristics using multivariate regression and also explore differences in medically related work absence costs. CONCLUSIONS: Women beneficiaries, age 50 to 64 years, treated for osteoporosis, breast cancer, and cardiovascular disease impose a significant financial burden on employers. This burden is due to higher levels of both inpatient and outpatient health care utilization compared to a random sample of similar patients.