OBJECTIVES: To evaluate the cost-effectiveness of regorafenib compared to the standard of care (SoC), in the treatment of metastatic colorectal cancer in previously treated patients. METHODS: A cohort partition model demonstrating the progression of mCRC patients towards death and evaluating clinical and economical outcomes was adapted to the Turkish setting. Event and mortality rates were derived from the CORRECT clinical trial. An expert panel, with the participation of experts in colorectal cancer, was established for the adaptation of clinical data to Turkish practice. The analysis was undertaken from payer perspective. The time horizon was taken as life time period. Costs of each health state included year 2015 local costs of medications, monitoring and events (TL/EUR currency rate was set at 2.9274; mid 2015). Incremental cost effectiveness ratios (ICER) per life year (LY) were calculated. Willingness-to-pay (WTP) threshold was set to two times of the local gross domestic product per capita per life years saved (adapted from World Health Organization definition) and was calculated as 18,481EUR. One-way sensitivity analyses were conducted to test the robustness of the model. RESULTS: The total cost of regorafenib was 2,173EUR higher compared to SoC. Regorafenib was associated with increment of 0.153 LYs, leading to an ICER of 14,188EUR/LY gained. Life years gained were 0.215 and 0.221 years in patients with wild type K-ras mutation and patients with less than 4 lines of treatment, respectively. Accordingly, ICER values were lower (10,280EUR and 8,308EUR) than overall group in these subgroups. Sensitivity analyses showed that the cost-effectiveness results are fairly insensitive to most inputs. CONCLUSIONS: Regorafenib, given its improvement in progression free survival and overall survival, and ICER values below WTP threshold, is suggested to be a cost-effective alternative in the treatment of metastatic colorectal cancer in previously treated patients in Turkey.