OBJECTIVES: Idiopathic dilated cardiomyopathy (DCM) is a life threatening heart disease and major reason for heart transplantation. Short time medical efficacy of immunoadsorption (IA) for DCM-patients has been demonstrated in first clinical studies. Objective of this study was to determine 5-year survival rates and direct medical costs to calculate costs per life year gained from a societal perspective. METHODS: Based on a previously published matched case-control study with clinical endpoints 34 patients of similar age, sex, duration and severity of DCM were included. Inpatient hospital costs of initial hospital stay were calculated from data extracted from patients' files and hospital's internal costing. Patients and treating cardiologists were contacted, thus determining resource use for primary and specialist's outpatient care, inpatients hospital stays and drugs during follow up. RESULTS: Patients treated with IA show a highly significant better survival: 5-year survival rate was 82% compared to 41%, Logrank statistics after Kaplan-Meier analysis p = 0,0071. Cost for IA were €28.400 per patient. Five-year medical costs were €118,600 per patient of IA group and €75,500 in controls; the costs per year of survival were €24,900 in IA group respectively €28,900 in controls. Incremental costs-effectiveness was €34,365 per life year gained. CONCLUSIONS: For the first time in a matched controlled study design survival analysis and economic evaluation of this new emerging technology for patients with DCM were performed. Although high initial treatment costs for IA occur the significantly better survival leads to reasonable costs per LYG.