OBJECTIVES: Hepatitis C (HCV) is a serious health problem affecting around 170 million people worldwide. A considerable health care burden is expected over the short to medium term, because of earlier peaks in incidence rates and the presence of undetected cases. The aim of the present study was to measure resource use and direct costs associated with the management of hepatitis C patients in a hospital-based Gastroenterology and Hepatology Service (GAS). METHODS: A model of patient flow through the department was constructed, and expert opinion was used to define relevant clinical sub-groups. Hospitalizations, outpatient care and diagnostic tests for the group as a whole and for each clinical sub-categoriy were calculated for the 4 month study period using information from hospital records, department protocols, and expert opinion. Unit costs were obtained from the hospital administrative database. Antiviral treatments were not included as they are not financed from the GAS budget. RESULTS: Data on use of resources and costs were obtained for a total of 584 patients. The total cost of treating HCV patients in the GAS for the study period was 600,343€ (1,028€ per patient). A total of 52% of these costs were attributable to diagnostic tests, 45% to hospitalization, and 3% to outpatient visits two. The most costly clinical categories in overall terms were post-transplant patients and chronic hepatitis patients, with total costs for the 4-month study period of 136,185€ and 116,502€, respectively. The two clinical categories with the highest per-patient costs were pre-transplant decompensated cirrhosis and hepatocarcinoma in decompensated cirrhosis, with per-patient costs for the study period of 4731€ and 4498€, respectively. Hospitalization was the principal cost driver in both instances. CONCLUSIONS: The study is useful in providing resource use and cost information by clinical sub-categories which will help estimate future resource use needs for these patients.