OBJECTIVES: Little is known about the use and effectiveness of new treatments for metastatic renal cell carcinoma (mRCC) in daily practice. In the Netherlands, this information is needed for expensive inpatient drugs to guarantee continued reimbursement. We evaluated the use and effectiveness of bevacizumab plus interferon alfa-2a (IFN) for patients with mRCC in Dutch daily practice. METHODS: A population-based registry was created to include patients newly diagnosed with mRCC from 2008-2010. These patients represent 55% of all patients in the Netherlands. Data were collected on patient and disease characteristics, treatments, dosages, treatment response, survival, adverse events and resource use.  RESULTS: To date, data on 615 patients have been collected. Average age at diagnosis was 66.4 years (range: 23-93) and 66% was male. 53% of these patients received systemic therapy. The majority (83%) was treated with sunitinib, whereas sorafenib is most often used as second-line treatment. Data from 34 patients treated with bevacizumab plus IFN in the first line were collected. The dosage corresponded with the recommended dosage (10 mg/kg). Since the mean weight of patients in daily practice was higher than the mean weight seen in the phase III trial (87.5 vs 76.0 kg), the mean dosage was also higher. Of the 34 patients treated with bevacizumab plus IFN, median overall survival was similar to that seen in the phase III trial (23.0 vs 23.3 months). CONCLUSIONS: Feasibility issues come into play when evaluating the use and effectiveness of expensive inpatient drugs in daily practice. Since bevacizumab plus IFN is not regularly used in daily practice, future cost-effectiveness analyses will have to be based on a careful synthesis of evidence from daily practice, the phase III trial, quality of life studies and other sources.