OBJECTIVES: : The purpose of this study was to determine the cost-effectiveness of cabazitaxel, based mainly on the TROPIC trial in 2nd line treatment of mHRPC relative to the standard of care at the time of launch of the drug. METHODS: : A Markov model was developed to comprise set of different health states each associated with costs, effects and probabilities of moving to other state.  In simulation, a cohort of defined patients are run through the model during the time period of choice, it's assumed that transitions between states only occurs at equidistant time-points and the interval is called a cycle. Because of the relatively short survival time of mHRPC patients, cycle length in the model was set at 3 weeks, corresponding to the length of one chemotherapy administration cycle. Transition rates between different states representing mHRPC disease progression were estimated based on progression of disease and survival rates from the TROPIC trial. RESULTS: : According to the approved labeling in Turkey, a subgroup of patients with ECOG PS 0-1 and measurable disease at baseline was identified on TROPIC results with a secondary analysis. The result of this analysis shows a similar OS outcomes with decreased death rates. Cabazitaxel was cost-effective compared mitoxantrone with cost per LYG of TRY66,862 given the threshold of TRY68,409 per LYG for the subgroup of the patients at ECOG PS 0-1 and with measurable disease at baseline. Although there has been no formal threshold for the cost-effectiveness ratio in Turkey, a threshold of TRY68,409 per LY gained was assumed based on WHO-CHOICE criteria (3xGDP percapita) CONCLUSIONS: : It is difficult for the results of the analysis to be interpreted because there is no official cost-effectiveness threshold in Turkey. However, from the WHO perspective; results showed that cabazitaxel is a cost-effective treatment with all ICER values compared to mitoxantrone, below TRY68,409.