OBJECTIVES: According to clinical guidelines It is estimated that 55% to 65% of people with prostate cancer will go on to develop metastatic disease (that is, the cancer spreads to other parts of the body). In over 90% of people with metastatic prostate cancer, the disease will initially respond to standard hormonal therapy but eventually become resistant to it. This clinical condition is described as castration-resistant prostate cancer, androgen-independent prostate cancer or hormone-refractory prostate cancer. The rationale intended for this study is to determine impact of sequential abiraterone then docetaxel on enhancing quality of life for patients and resources utilization through cost utility study, over a time horizon of 5 years. METHODS: A cost utility analysis from the perspective of the National Fund was conducted. A Markov model was applied with four health states. Utility data were incorporated in the model to make adjusted results. The structure of this model reflects the natural history of prostate cancer and current treatment strategy compared to the medical literature related to the disease.The model conforms to real practice of management of prostate cancer in Egypt. one way sensitivity analysis was conducted Costs used were the local ones according to the national fund list. Discounting was applied at 3.5% . RESULTS: During the five-year time horizon, total QALY gained for the abiraterone arm was 295 QALY. Total QALY gained for docetaxel arm was 197 QALY. That yields a difference of QALY was 98 Total cost for the abiraterone arm was 21,668,872 EGP. Total cost for docetaxel arm was 19,051,586 .EGP. The ICER is 26,725 EGP per QALY gained. The model is highly sensitive to PFS and cost of abiraterone. CONCLUSIONS: The result of this study suggest Abiraterone is the dominant therapy. for efficant allocation of health care system resources and to achieve better health in the Egyptian population