OBJECTIVES: Kidney cancer can be treated with a combination of biological agents, such as interferon or interleukin (IL) plus chemotherapy or by these agents alone. Recently, a new class of drugs showed activity in the treatment of this disease: the kinase inhibitors Sorafenib and Sunitinib. Concerns on costs about these new agents have emerged, since they are new and expensive drugs. We performed a cost-minimization analysis about the costs of each of these treatment strategies. METHODS: We identified, from international guidelines, the major strategies recommended to treat metastatic kidney cancer. Then, we retrieved the original publications of each strategy and extracted from those papers data about drug doses, hospitalization rates and medical care. We developed a Markov model to calculate the events rates and the costs for each strategy during six months of treatment. The sources of costs were hospitals, insurance companies and oncology clinics in Sao Paulo, Brazil. We used the Brazilian prices in local currency (Real) and converted them to US dollars, according to the exchange rates of december/2006. RESULTS: Total mean cost per patient during the six months studied was US$ 41218.02 for biochemotherapy, US$ 200350.07 for IL, US$ 35510.70 for Sunitinib and US$ 32701,86 for Sorafenib. Most of the cost for all strategies was due to drug costs: 93%, 53%, 94% and 91% respectively. CONCLUSION: The kinase inhibitors have lower total costs than biochemotherapy and IL for the treatment of kidney cancer. Between the kinase inhibitors, Sorafenib has a cost 10% lower.