OBJECTIVES To estimate the budget impact resulting from the introduction of aflibercept for the treatment of metastatic colorectal cancer (mCRC) within drug program in Poland. METHODS Analysis was performed in 3-year time horizon (2014-2016) from the public payer (NHF) perspective. Target population is defined as adult patients with mCRC that is resistant to or has progressed after an oxaliplatin-containing regimen (including patients who experienced distant relapse within 6 months of completion of oxaliplatin-based adjuvant therapy). Eligible patient population was estimated by compilation of following data: epidemiological studies, local market study, IMS data, survey among Polish oncologists. Market shares of different regimens (aflibercept 4 mg/kg +FOLFIRI, bevacizumab 10 mg/kg +FOLFOX-4, FOLFIRI) were projected based on the NHF data and experts’ opinion. Following cost categories were included: drug acquisition and administration (anti-VEGF, chemotherapy), diagnostics, monitoring and adverse events (grade 3-4). RESULTS With the introduction of aflibercept, estimated annual number of patients starting aflibercept treatment will be 90, 209 and 224 in year 2014, 2015 and 2016, respectively.Total annual expenditures in year 2014, 2015 and 2016 were calculated to be 39.3, 40.3 and 41.2 million PLN in scenario without aflibercept, compared with 37.4, 34.9 and 35.0 million PLN, respectively, with the introduction of aflibercept.In case of aflibercept reimbursement, the NHF would save 1.9 million PLN in year 2014, 5.3 million PLN in year 2015 and 6.1 million PLN in year 2016. CONCLUSIONS The introduction of aflibercept would result in savings for the NHF in Poland, mainly as a consequence of reduced pharmacological costs compared to bevacizumab.