OBJECTIVES: To estimate the budget impact of bevacizumab combinations in the metastatic colorectal cancer (mCRC) treatment and chemotherapy with anti-EGFR  for first and second line according to the Russian healthcare system. METHODS: The budget impact analysis was conducted. Direct expenses associated with mCRC and resulting follow-up costs were calculated using general tariff agreement of Russian statutory health insurance and official national statistics (accepted exchange rate was 1 $ = 30 RUB).     RESULTS: Bevacizumab treatment combinations in the mCRC therapy provided cost saving benefits compared with chemotherapy with anti-EGFR for first and second line therapy. Total healthcare costs of mCRC therapy were approximately 1 187 115 RUB (39 571 $) in bevacizumab+FOLFIRI 1 line therapy, 662 242 RUB (22 075 $) in bevacizumab+CAPOX 2 line therapy and 2 518 311 RUB (83 944 $) in cetuximab+FOLFIRI 1 line therapy, 872 226 RUB (29 074 $) in bevacizumab+FOLFOX4 2 line therapy. Treatment of mCRC using bevacizumab treatment combinations compared to chemotherapy with anti-EGFR leads to cost savings of 1 541 181 RUB (51 373 $).  CONCLUSIONS: The results of budget impact analysis illustrate that bevacizumab treatment combinations in the mCRC treatment in comparison with chemotherapy with anti-EGFR has potential to reduce Russian healthcare system total costs for mCRC treatment.