OBJECTIVES:  Data on healthcare management of patients with metastatic colorectal cancer (mCRC) are scarce in France. A study was conducted to evaluate the feasibility of identifying treatment lines in mCRC at patient level using the French hospital DRG base payment system. METHODS:  This system provides data related to hospitalized patient characteristics, clinical diagnoses and medical procedures. Data on expensive therapies registered on the ex-T2A list and charged in addition to DRG tariffs are also available. A step-by-step approach was implemented with experts to establish an algorithm describing treatment pathways and was applied to patients with a first hospitalization for mCRC (ICD-10 codes: C18-C20 and C77-C79) in 2011 and followed during a 4-year period. RESULTS:  21,003 patients were identified in 2011, 65.7% received chemotherapy, and 52.8% of them at least one targeted therapy (47.2% receiving anti-EGFR therapy and 52.7% bevacizumab without anti-EGFR therapy). Patients with at least one targeted therapy were younger than patients receiving a chemotherapy (mean age of 61.6 vs. 66.1 years). The mean number of hospital stays was higher for patients receiving a targeted therapy (40 vs. 20, respectively). Due to lack of details on clinical data and on chemotherapy administration, we were not able to identify treatment lines. Others sources were then explored, e.g. the French national representative claims databases (EGB/SNIIRAM), which do not permit to overcome these limitations. CONCLUSIONS:  Even if characteristics of patients, their disease and some drugs administrations (the most expensive ones) can be described accurately, current French databases do not allow to adequately identify complete mCRC treatment lines. There is a need to adapt current tools to collect additional data. Indeed, with new coming therapies, more precise epidemiological, clinical and economic information would be helpful for decision makers.