OBJECTIVES: To perform economic evaluation of pazopanib in comparison with sunitinib, sorafenib and bevacizumab + interferon α-2a for patients with metastatic renal cell carcinoma (mRCC). METHODS: Indirect comparison was performed to assess the relative efficacy of studied drugs. Pazopanib was compared with sunitinib and bevacizumab + interferon α-2a in the first-line treatment and with sorafenib in the second-line treatment of patients with mRCC. The probability of progression-free survival (PFS) was the criteria of clinical efficacy. Costs of drugs were calculated based on data about the prices of public purchases. Cost-minimization analysis was performed. One-way sensitivity analysis was made to assess the impact of prices’ variations (minimal – maximal price range) on the results. RESULTS: Indirect comparison showed no statistically significant differences in PFS between compared drugs. The rate of severe adverse events was low for all drugs and should not affect the costs. The cost-minimization difference for pazopanib was —371.44 thousands rub (—11.09 thousands $) in comparison with sorafenib, —660. 12 thousands rub (—19.70 thousands $) in comparison with sunitinib and —1.98 millions rub (—59.20 thousands $) in comparison with bevacizumab + interferon α-2a per patient. The sensitivity analysis showed that variations in prices do not affect the results and pazopanib remains a cost-saving option. CONCLUSIONS: Pazopanib is more efficient alternative in comparison with sunitinib, sorafenib and bevacizumab + interferon α-2a for patients with mRCC.