OBJECTIVES: To develop a cost-effectiveness evaluation of the use of capecitabine+docetaxel vs gemcitabine+docetaxel in patients with recurrent breast cancer who previously failed to anthracycline chemotherapy and/or with metastatic disease. METHODS: A Markov model was built in order to show the clinic course of a cohort of patients with recurrent breast cancer who previously failed to anthracycline chemotherapy and/or with metastatic disease in order to set a quantitative comparison between the costs associated in the schemes at the institutional Mexican context. The model includes three health states (no progression, progression and death), within a 12 months horizon. The outcomes obtained as effectiveness measure is Progression-Free Survival (PFS); in order to define resources and procedures to set costs a literature search for economic evaluation and different disease management alternatives was done; the costs used to run the model included diagnosis, treatment, following and medical support. The threshold to define a therapy as cost-effective was fixed at US$25,020.00 (least than three times Mexican GDP per capita) following the recommendations of WHO’s Commission on Macroeconomics and Health. RESULTS: The total management cost at 12 moths with capecitabina+docetaxel is US$23,117.90 vs US$23,978.12 for gemcitabina+docetaxel. The Cost-effectiveness plane indicates capecitabina+docetaxel is a cost-effective therapy; with a probability of 0.50 of being cost saving and 0.80 to be cost-efective is at a US$25,020.00 threshold. CONCLUSIONS: Results show that capecitabine+docetaxel is a cost effective therapy when comparing with gemcitabine+docetaxel therapy in first line therapy for patients with breast cancer who previously failed to anthracycline chemotherapy and/or with metastatic disease.