Abiraterone acetate (Abi) therapy showed survival and clinical benefits in the treatment of metastatic castration-resistant prostate cancer (mCRPC) in phase III trials. In Quebec, Abi reimbursement was approved for docetaxel-naïve and refractory patients in 2014 and 2012, respectively. OBJECTIVES: Evaluated the cost-effectiveness and survival impact of Abi treatment in the management of CRPC post-docetaxel. METHODS: The study cohort was selected from the public healthcare insurance programs: Régie de l’Assurance Maladie du Québec (RAMQ) and Med-Echo databases. It consisted of patients with CRPC starting chemotherapy or abiraterone treatments beteween 2009-2010 (docetaxel), defined as pre-Abi era, and 2012-2013 (docetaxel+Abi), defined as Abi era. Survival was evaluated by Kaplan-Maier and the difference in survival between pre-Abi and Abi eras by log-rank test. Association between Abi exposure and survival was evaluated by cox proportional hazards model adjusted for co-variables. The incremental cost-effectiveness ratio was obtained by dividing changes in costs (Docetaxel alone, Docetaxel+Abi) and survival in the two periods. RESULTS: Survival was significantly increased by the addition of Abi to CRPC management. Mean survival were 11.47 (±0.6; N=115) vs