OBJECTIVES: This study aims to evaluate the clinical, medication and economic outcome among advanced CRC patients who were relapsed to metastasis in Taiwan using reimbursement and cancer registry databases.   METHODS: The outcome data was form 2 million sampling reimbursement data base of Taiwan’s National Health Insurance Research Database (NHIRD) and diseased stage was derived from the Taiwan Cancer Registry (TCR) between 2007 and 2011. Diseased stage diagnosed for the first time ever of CRC patients was recorded in TCR. Merged database was provided by Health and Welfare Statistics Application Center (HWSAC), Ministry of Health and Welfare, Taiwan. Metastasis relapse of the advanced CRC patients was identified if the patients were prescribed the approved target therapies, i.e. Avastin or Erbitux. Descriptive statistics were derived and summarized; Cox regression was used to estimate the difference of the relapse proportion and mortality.  RESULTS: After eliminating the other previous cancer coded in the database, and non- reported diseased stages in the merged database. 2,477 patients were derived and enrolled into the analysis. Relapse rates were 5.8% and 19.2% among stage III and IV CRC patients with median relapse days of 590 and 437. Mortality rates were 21.9 % and 64.6% with median survival days of 765 and 652. Comparison of the relapse rates among different stages was statistical significant with p < 0.0001. Overall costs were estimated as an average of 103,616 and 162,714 USD per person during the first year since diagnose. CONCLUSIONS: Relapse to metastasis stage and mortality rate in advanced CRC are still high and estimated medical expenditure increased 57% between stage 3 and stage 4 and is possibly due to the high metastatsis relapse rate.