The aim of this study was to estimate costs of treatment for Hodgkin's disease (HD) and the outcome in health in terms of quality-adjusted life-years (QALYs), and compare these to a constructed no-treatment alternative. All 55 patients treated for HD at the oncological unit of the University Hospital of Tromso between 1985 and 1993 were included. The total treatment costs (medication, hospital stay, hospital hotel stay, radiotherapy, travelling, loss in production, i.e. work) were retrospectively estimated for all patients. In December 1993, the 49 survivors were sent a EuroQo1 questionnaire recording quality of life: 42 responded. The mean quality of life score was 0.78 on a 0-1 scale, and the mean total cost of treatment was pound 12512. The total treatment costs were significantly higher in patients with advanced clinical stages of the disease (P = 0.0006), B-symptoms (fever, sweats, weight loss) (P = 0.0027) and relapse (P < 0.0001). The costs of one QALY (with production gains included and using a 10% discount rate) were estimated at pound 1651. When excluding production gains and using a 5% discount rate, the figures became pound 1327. This makes HD one of the most cost-effective malignancies to treat. Copyright (C) 1996 Elsevier Science Ltd