OBJECTIVES: The purpose of this study was to explore the cost-effectiveness of abiraterone acetate (abiraterone) vs. cabazitaxel in metastatic castration-resistant prostate cancer (mCRPC) patients who progressed after docetaxel in Kazakhstan. METHODS: Since no head-to-head trial data were not available for Abiraterone against cabazitaxel, indirect profitability model was developed using clinical data (progression-free survival (PFS), overall survival (OS), adverse events (AEs)) from the pivotal Phase 3 clinical trials COU-AA-301 (Abiraterone) and TROPIC (cabazitaxel). The basic assumption in the model was that the two comparator arms in the trials were "palliative" and are therefore equivalent. Using the resources, in particular for controlling the adverse events was calculated based on data Kazakhstan. For validation purposes, a secondary analysis was conducted using international  resources use data. The analysis used a local expenditures 2011-2012, undiscounted. Hospitalization, day hospital visits, medications, and laboratory tWe developed a Markov microsimulation model with a lifetime horizon and a direct health-care cost perspective. The patient history was recorded and was used in calculations of transition probabilities, utilities, and costs. ests were taken from the public officially published rates. The cost of purchasing drugs came from recent price lists . Calculations were based on the average duration of treatment for each agent. RESULTS: The total cost of treatment was lower for Abiraterone compared with cabazitaxel. Higher costs for the purchase of medicines for Abiraterone were offset by lower administrative expenses and lower AE management costs. Results were confirmed by secondary analysis. All sensitivity analyzes from the point of view of the model parameters and modeling assumptions are consistent with the expected findings, which confirmed both internal and external consistency of the model. CONCLUSIONS: Abiraterone is a potentially cost-effective option compared with cabazitaxel in the health care system in Kazakhstan.