OBJECTIVES: Sorafenib is an oral multi-kinase inhibitor that targets tumour cell proliferation and tumour angiogenesis. In the TARGET study (phase III trial), sorafenib plus best supportive care (BSC) significantly prolonged progression-free survival (PFS) compared with BSC alone in patients with unresectable and/or metastatic renal cell carcinoma (mRCC). The objective of this study was to assess the cost-effectiveness of sorafenib plus BSC versus BSC alone in mRCC patients in Turkey. The study was undertaken from a Turkish health care payer perspective. METHODS: A Markov model was developed to estimate costs and outcomes associated with sorafenib + BSC and BSC alone. The model tracked patients with mRCC through three health states: PFS, disease progression and death. PFS and survival were extrapolated based on patient level trial data (TARGET) over a patients’ lifetime. Health effects were expressed as life years gained (LYG). Incidence of adverse events (AEs) were also obtained from TARGET. Resource utilization data were obtained via expert clinical opinion and included physician visits, hospitalizations, monitoring, treatment of AEs, etc.  Unit costs were taken from the Social Security Institution’s official price list. Costs and effects were evaluated over a lifetime and discounted at 3%. Results were presented as incremental cost/LYG. Deterministic and probabilistic sensitivity analyses were also conducted. RESULTS: The incremental survival benefit with sorafenib was 1.269 LYG. The lifetime cost per patient was 4,080 TL for BSC and 47,665 TL for sorafenib + BSC. The incremental cost-effectiveness ratio of sorafenib + BSC was 34,342 TL per LYG compared with BSC alone. Sensitivity analyses confirmed the robustness of the model results. CONCLUSIONS: Compared with BSC alone, sorafenib + BSC is a cost-effective therapy option in the treatment of unresectable and/or metastatic renal cell carcinoma (mRCC) patients in Turkey.