The problem of original drugs substitution on generics presents in the Russian clinical practice due to rational expenditures allocation. Pharmaceutical bioequivalence of generic should be confirmed by therapeutic one. Only after such kind of confirmation the mentioned substitution could be made in a different segments of doctors’ practice especially in anticancer chemotherapy. OBJECTIVES: To evaluate the clinical-economic interchangeability of the original oxaliplatin Eloxatine (EL) and local generic Exorum (EX) in the chemotherapy of mCCR. METHODS: The  retrospective  clinical-economic  analysis  of  FOLFOX scheme  for  chemotherapy  of mCCR with EL and EX in the real practice has been performed. 50 case histories (23 with using of EL, 27 – EX, was used nomogram of Altman's) were studied. The calculation of direct cost and cost-effectiveness ratio (CER) based on “partial regress + stabilization”  parameter  no  less  than  80%  has  been  performed. RESULTS: For achievement of equal efficacy EL had  less number of chemotherapy cycles and total dosage compared with  EX  (5,0  and  7,3;  670  mg  and  900  mg  respectively). Adverse effects were more frequent  in EX vs EL (59 and 38, respectively) and caused additional costs and prolonged hospitalization (9 days/patient compared to EL group). The utilitarian EX program cost per patient was  less compared to EL by 7,7%. In the same time CER calculated with total costs due to side effects treatment was practically equal (difference is 1,6% only). Cost prognosis for equal efficacy results with EL using  is  less by 28,6% vs EX. The alternative scenario has confirmed the cinical-economic added value of EL. CONCLUSIONS: The change of original EL for generic EX in FOLFOX scheme for mCCR has no economic advantages. EL substitution  leads  to  increased  number  of  chemotherapy cycles,  higher  dose  of  oxaliplatin,  higher  rate  of  adverse effects and higher costs.