OBJECTIVE: Chronic Hepatitis B (CHB) can lead to cirrhosis and hepatocellular carcinoma. This study aims to estimate resource utilisation (RU) and costs associated with CHB management in Sweden, from a health-system perspective. METHODS: Medical management patterns were estimated for: Chronic Hepatitis B (CHB), Compensated Cirrhosis (CC), Decompensated Cirrhosis (DC), and Hepatocellular Carcinoma (HC). Resources considered were physician visits, drug therapy, lab tests, diagnostic/therapeutic procedures and hospitalisation. RU data were obtained from a Delphi panel of 5 hospital specialists. Complications considered for DC were: ascites, variceal haemorrhage, hepatic encephalopathy, and bacterial peritonitis. For HC, RU was estimated for the first year post identification of the cancer. Based on RU, 2005 direct costs were estimated per health state. RESULTS: Resource utilisation increased across disease states, reflecting disease progression. The average annual cost (range) of each state was: CHB: SEK 8,001 (SEK 1,891 – SEK 17,011); CC: SEK 34,649 (SEK 7,378 – SEK 93,185); DC: SEK 135,783 (SEK 20,171 – SEK 442,785); HC: SEK 280,009 ( SEK 52,759 – SEK 619,031); Average LT cost was SEK 668,027. Hospitalisation is a key cost driver in DC and HC states. No GP visits were reported. Hospital admissions were unneeded in the CHB state. For CC, 5.8% of patients needed 1.25 admissions (average 0.08) and in DC, 68% needed 2 admissions (average 1.4). In HC state, all patients were admitted on average 3.4 times. Average LOS in DC and HC states was 11 days. 35% of HC patients needed hospice admission with an average LOS of 38 days. Common procedures include paracentesis (60%), sclerotherapy (50%), and TIPS (30%) in the DC state, and paracentesis (70%), radiofrequency ablation (15%), and ethanol injection (10%) in HC. CONCLUSIONS: RU and costs increase with disease progression: costs for the HC state are more than 30 times those for the CHB stage.