Medical advances, particularly technological and pharmaceutical, are continually increasing, and this pattern is likely to continue. In contrast to this technological and pharmaceutical expansion, the reality of a global recession and the need to cut costs are universal health-care challenges. Herein the authors review the approximate cost estimates for a proven strategy to manage colorectal peritoneal metastases, namely cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy and different tools government or heath care providers use in deciding which treatments to fund and remunerate.