Objective: To evaluate the cost effectiveness and cost utility of sunitinib compared with interferon-alfa (IFN-alfa ) for first-line treatment of patients with Metastatic Renal Cell Carcinoma (mRCC) from Colombia third-party payer perspective. Methods: A Markov model was developed and adapted to Colombian circumstances to evaluate the cost-effectiveness of sunitinib vs. IFN-alfa. The model projected survival and costs in 6-week cycles based on extrapolation of the trial survival data. The reference case analysis followed the patients until death or for up to 1 year, however longer time horizons were considered in the analysis (two, five, and ten years). Effectiveness was measured in terms of progression-free life years (PFLY), life-years (LY) gained and quality adjusted life-years (QALY) gained. Resource utilization and unit cost data were collected from: A series of 15 patients with mRCC treated in Colombia, Colombian expert clinical opinion and the cost of medication was extracted from a Colombian Cancer reference institution (Liga Colombiana de lucha contra el cáncer). Costs and benefits were discounted annually at 5%. All costs were calculated in 2006 Colombian pesos. Univariate sensitivity analyses was conducted. Results: For the reference case: the cost analysis suggested a difference in favor of sunitinib of US$5711. The treatment with sunitinib was associated with incremental gain in: PFLY of 0.23, overall survival of 0.05 YL and QALY of 0.07. The incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR) showed negative values, which indicated that sunitinib is cost saving versus IFN-alfa. In the longer time horizon analysis the sunitinib is dominant in the first two years; for 5 and 10 years analysis the ICER and the ICUR are around US$8200 and US$6400 respectively. Conclusion: This analysis indicated that sunitinib is a cost-effective treatment compared with IFN-alfa as a first-line treatment in mRCC in Colombia.