OBJECTIVES: Pharmacoeconomic analysis of direct medical costs of mCRC therapy using XELOX/FOLFOX4, XELOX + BV/FOLFOX4 + BV. METHODS: Costs of diagnosis, medical services and hospitalization were based on the price-list for diagnostic and therapeutic procedures of Cancer Research Center n.a. N.N.Blokhin RAMS. The medical services patient should receive during the treatment and the frequency of their appointments were taken from the standards of medical care for patients with colon and rectum cancer. Cost analysis of anticancer drugs (16 courses of XELOX/XELOX + BV, 24 courses of FOLFOX4/FOLFOX4 + BV) and related drugs were based on the information about maximum selling import prices, registered and entered into the State Register of prices of vitally essential drugs. The cost of other drugs was based on a database of retail prices for drugs in pharmacies, which was subsequently reduced by trade discount.   RESULTS: In was calculated that the cost of diagnosis was 16,757 rubles and the medical services - 379,815 rubles. The mCRC therapy as a first line by XELOX was 1,172,731 rubles and by XELOX + BV – 2,526,110 rubles; by FOLFOX4 - 1,487,627rubles and by FOLFOX4 + BV – 2,843,558 rubles. The cost saving in applying the regime XELOX compared to FOLFOX4 regime amounted to 314,896 rubles. In applying the regime of XELOX in combination with BV in comparison with the regime of FOLFOX4 in combination with BV amounted to 317,448 rubles. Sensitivity analysis showed that the decrease and increase of the cost of capecitabine and bevacizumab in 20% for XELOX/XELOX + BV does not exceed the cost of regimes FOLFOX/FOLFOX4 + BV. CONCLUSIONS: From the pharmacoeconomic point of view the most optimal is the use of XELOX and XELOX + BV regimes because of lower costs for neutropenia treatment, associated with an increased risk of infectious complications, as well as with a large number of hospitalization days.