OBJECTIVES: To assess economic appraisals of chemotherapy regimens for metastatic colorectal cancer (mCRC) published in peer-reviewed journals. METHODS: A PubMed search of English-language documents published up to October 2004 was conducted using the search terms: "chemotherapy", "metastatic", “colorectal cancer”, and "economic", “cost-effectiveness”, or "cost-benefit". Additional publications were identified from references, reviews, and meta-analyses. Publications were reviewed for information on the type of cost analyses, year of publication, journal, country, perspective, type of chemotherapy assessed, data collection methods, sponsorship, and types of sensitivity analyses conducted. RESULTS: Economic analyses were published on eight regimens. Seven of the 14 published studies were published from a UK perspective, and 2 each from a French and a Dutch perspective; no study has been published from the US perspective. Ten studies were cost-consequences and four were cost-effectiveness analyses. Limited documentation was provided on sources of costs for medical resource use. Adjustments for quality of life were considered in sensitivity analyses in two studies designed to inform guidance by the UK's National Institute of Clinical Excellence. Overall, drug costs accounted for 1%-37% of total expenditures for 5-flourauracil + leucovorin (5FU/LV) regimens, in contrast to 47%-83% of total expenditures for newer combination regimens (e.g., irinotecan + 5FU/LV, oxaliplatin + 5FU/LV, capecitabine). No formal analyses were published on Avastin (bevacizumab) or Erbitux (cetuximab). Discounting for future costs and benefits was not done in any analysis. CONCLUSIONS: Some prominent novel regimens for mCRC have no publicly available economic appraisal. Among the few published studies on older regimens, most omit components such as quality-of-life adjustments, discounting, and transparent statements on data sources for prices that are recommended in ISPOR's statement on “Good Research Practices – Modeling Studies.”