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Abstract Introduction Although extracorporeal photopheresis (ECP) is a promising second-line therapy in the treatment of chronic graft-versus-host disease (cGVHD), its use is limited by its high cost. This study aims to describe the clinical evolution of patients who underwent ECP therapy for cGVHD and to perform an economic analysis of the therapy Methods This was a case series between 2016 and 2020 describing the clinical response to ECP and a micro-cost analysis of the therapy using time-driven activity-based costing. Results Six patients underwent ECP for corticosteroid-dependent cGVHD The cost per ECP session is 14,960.90 Brazilian reais (BRL), which primarily consists of the ECP kit with an activator (82.78%), followed by the hospital's physical structure (14.66%), human resources (2.48%) and exams/inputs (0.08%). The number of sessions performed ranged from 2 to 42. The total cost of the therapy per patient ranged from BRL 30,000 to 500,000. Conclusion The response of the patient with cGVHD to treatment with ECP was variable. These micro-costing results can be used to develop remuneration and cost control strategies in hematopoietic stem cell transplantation programs, as well as in further economic studies. (ECP secondline second line graftversushost graft versus host cGVHD, , (cGVHD) 201 202 microcost micro timedriven time driven activitybased activity based costing corticosteroiddependent corticosteroid dependent 1496090 14 960 90 14,960.9 BRL, (BRL) 82.78%, 8278 82.78% 82 78 (82.78%) hospitals hospital s 14.66%, 1466 14.66% 66 (14.66%) 2.48% 248 48 (2.48% examsinputs exams inputs 0.08%. 008 0.08% . 0 08 (0.08%) 42 30000 30 000 30,00 500000 500 500,000 variable microcosting programs studies (cGVHD 20 149609 1 96 9 14,960. (BRL 827 82.78 8 7 (82.78% 146 14.66 6 (14.66% 2.48 24 4 (2.48 00 0.08 (0.08% 3000 3 30,0 50000 50 500,00 14960 14,960 82.7 (82.78 14.6 (14.66 2.4 (2.4 0.0 (0.08 300 30, 5000 5 500,0 1496 14,96 82. (82.7 14. (14.6 2. (2. 0. (0.0 500, 149 14,9 (82. (14. (2 (0. 14, (82 (14 ( (0 (8 (1