BACKGROUND: Abiraterone is the oral drug indicated for treatment of patients with metastatic castrate-resistant prostate cancer (MCRPC). COU-AA-301 and COU-AA-302 RCTs showed higher overall and progression-free survival for combination of abiraterone and prednisone both before and after the first line of chemotherapy compared to prednisone alone. However, wide use of abiraterone is restrained in Russia due to its high cost. OBJECTIVES: The aim of the study is the pharmacoeconomic evaluation of abiraterone used before chemotherapy in patients with MCRPC from Russian healthcare system perspective. METHODS: Using Markov model we estimated life expectancy and costs for two therapy options: (1) consecutive use of abiraterone, docetaxel and cabazitaxel and (2) consecutive use of docetaxel and cabazitaxel (all regimes include prednisone). Costs related to these options include medication, adverse events treatment, treatment of bone metastases, premedication before chemotherapy, pain relief and visits to oncologist. Incremental cost-effectiveness ratio (ICER) was calculated for the 1^st treatment option vs the second one and compared with ICER for antineoplastic drugs that are already included in regional governments reimbursement programs (i.e. bevacizumab, trastuzumab, cetuximab and erlotinib). RESULTS:  Modeled life expectancy is 32,4 monthts for the patients treated by the 1^st treatment option, and 19,5 month for those treated by the 2^nd