Colorectal cancer (CRC) is a genetically heterogeneous disease, which prognosis and efficacy of treatment are determined by the localization of the primary tumour (left- and right-sided tumours). CRC ranks high in prevalence in the Russian Federation, a quarter of cases are diagnosed at stage IV. The choice of the most optimal therapy regimen is a topical issue for a modern oncologist, who has time-proven combinations of chemotherapy and modern targeted drugs in the arsenal. The aim of this article is to provide a pharmacoeconomic review, taking into account both clinical and economic parameters of one or another CRC pharmacotherapy regimen. As a result, it was found that the use of chemotherapeutic regimens in the first- and second-line therapies of patients with CRC is the most pharmacoeconomically justified as compared with the use of targeted therapy at the initial stage.