The use of abiraterone acetate for the treatment of metastatic castration-sensitive prostate cancer is clinically effective. Compared with standard of care, abiraterone acetate was associated with increased overall survival, increased prostate cancer–specific survival, increased progression-free survival, and improved quality of life. Patients treated with abiraterone acetate were at higher risk for grade III to grade V adverse events (severe, life-threatening, or fatal) and were more likely to discontinue treatment compared with standard of care. The incremental cost-effectiveness ratios for both brand and generic abiraterone acetate were estimated to be higher than common willingness-to-pay thresholds.