6078 Background: Incidence of HCC is rising in the United States. Published cost data of HCC are obsolete, as pt populations analyzed were from >10 y ago and treatment options have dramatically changed. The objective of this study was to update the literature by quantifying incremental direct medical costs and full resource use of HCC from a current U.S. perspective and using patient level data. Methods: Deidentified, individual-level healthcare claims data from MarketScan were retrospectively analyzed. Pts diagnosed 1/07-12/08 with ≥2 primary HCC claims (ICD9 155.0); continuous enrolment; ≥180 days coverage before HCC; no prior claims for secondary HCC (ICD9 197.7), transarterial chemoembolization (TACE), liver transplant, or hospice were included. Pts were followed from HCC diagnosis until healthcare coverage end or 3/31/09 and matched 5:1 to subjects without HCC by 10-y age increments, sex, health plan type, and U.S. census region. Univariate and multivariate analysis was conducted at per member per month (PMPM) level. Results: Mean age of HCC pts (n=1475) was 62.6 y and matched cohort (n=7375) was 62.1 y; 67.9% in each group were male. Incremental univariate and multivariate annualized total medical expenses of HCC pts were $87,240 and $36,996 greater, respectively, than those without HCC. HCC treatment procedures were 32.2% of outpt costs (19.6% IV chemo, 10.5% TACE). Conclusions: This retrospective U.S. database analysis quantified significantly greater costs among HCC patients than those without HCC and that older agents are still commonly used. Additional expenses were largely attributed to inpt costs, while one-third of outpt costs were attributed to procedures. Cost expenditures have increased considerably based on data from 10 y ago. These data may be useful to support future cost analyses and cost effectiveness model of HCC. Univariate costs, mean PMPM ($) HCC pts HCC-free subjects Cost ratio P value Inpt 3,745 238 15.71 < 0.0001 Procedures 231 TACE 145 RFA 39 IV chemo 46 Outpt 3,774 386 9.77 < 0.0001 Procedures 1,217 TACE 397 SIRT 56 RFA 25 IV chemo 739 Drug 529 153 3.46 < .0001 Sorafenib 280 Total 8,048 778 10.35 < 0.0001 Pt-mos (n) 12,116 119,510 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Bayer Amylin, Astellas Pharma, Bayer, Bayer-Onyx, Exhalenz, Gilead, Ikaria, Pfizer, Salix, sanofi-aventis, Takeda, Vertex Bayer Bayer, Gilead, Intercept, Roche, Salix, sanofi-aventis Up-to-Date