OBJECTIVES: With 75,880 patients under medical supervision in 2007, prostate cancer is the fourth most frequent cancer in Russia and the first in terms of increase of mortality (+21,6%) with ,8909 deaths/year. Moreover metastatic prostate cancer (MPCa) holds more than 60% of these patients at the same time being the leading expenditure driver. The purpose of this study was to evaluate the burden of illness and total per patient costs, associated with managing patients with (MPCa) in the 12 months following diagnosis in Russia from perspective of public healthcare system. METHODS: A costing model combined the data of official algorithms (standard of treatment approved by Ministry of Health) and guidelines of MPCa management, as well as local experts opinion and published data on resource use and unit costs from published sources to calculate total per patient direct costs of MPCa treatment. Direct costs of MPCa include expenses on medical services and pharmacotherapy (cytostatics, hormones and antihormones, accompanying and other drugs). As initial treatment following diagnosis radiotherapy was used most frequently. Use of chemotherapy was low. Relapse and mortality were not factored into the model. Total direct medical costs of initial treatments following diagnosis per patient were calculated for MPCa in 12 months timeframe. RESULTS: Total per patient direct costs following diagnosis was 810,529 roubles. Analysis of the costs structure showed that hormone therapy represents a significant higher cost to surgery, while radiotherapy had the highest cost proportion. Pharmacotherapy was the major driver of MPCa treatment cost (more than 50% share from all expenditures). CONCLUSIONS: In this study quantifying the cost of MPCa treatment in Russia was found a significant resource utilization and healthcare costs, along with the major cost drivers. Given the number of new cases diagnosed in Russian Federation, these estimates suggest a large total spending on the disease.