OBJECTIVE: To assess the impact of anemia on medical resource utilization in cancer patients undergoing chemotherapy. METHOD: Medical charts of 116 cancer patients (various tumor types) from 33 community oncology practices across the United States, treated with chemotherapy in 2000-01 and not treated with erythropoietic therapy, were evaluated. Anemia was defined as hemoglobin (Hb) of <12 g/dL at baseline or at any point of time during 28 weeks following chemotherapy initiation. Medical resource utilization data on two major cost drivers, emergency room (ER) visits and hospitalizations, were compared for the anemic and non-anemic groups. RESULTS: Fifty eight (50%) patients were anemic. Of the anemic patients, 26 (45%) had mild anemia (Hb 10.0 - 11.9 g/dL) and 4 (7.5%) had moderate anemia (Hb 8.0 - 9.9 g/dL) at baseline. The remaining 28 (48%) patients became anemic during chemotherapy. There were no significant differences between the anemic and non-anemic groups relative to co-morbidities, tumor type, cancer stage, radiotherapy, and prior chemotherapy. There was numerically higher amount of medical resource utilization in anemic group. For moderate to severe anemic sub-group, there was statistically significant (despite small patient numbers) higher utilization than in non-anemic group: mean hospital admissions 0.58 vs. 0.19, p=0.040; mean number of hospital admissions 5 days 0.25 vs. 0.07, p=0.58; and mean ER visits 0.47 vs. 0.02, p=0.022. CONCLUSION: Our study demonstrated higher medical resource utilization associated with anemia in chemotherapy-treated cancer patients. More severe anemia may result in even higher utilization.