OBJECTIVES: Capecitabine  (C) is approved in Brazil for the treatment of breast cancer (BC), 2nd or subsequent lines. In the private sector, it's not often used, due to the fact that health insurance plans (HI) do not offer coverage for oral (PO) chemotherapy (CHEMO), only for intravenous (IV). Our aim was to determine if the use of C could spare costs if adopted by HI. METHODS: We searched Evidencias Database for BC patients eligible for the use of C, in the year of 2008. This database has information from over 2 million of users of 14 HI. We identified the IV CHEMO actually used and the costs paid. Then, based on the data of each individual patient and in the length of use of CHEMO, we calculated the associated costs in a scenario where C replaced the IV CHEMO used. Also, we performed some sensitivity analysis based on different percentages of substitutions of IV by PO chemo. We considered only the prices of drugs. RESULTS: We found 518 BC patients eligible for C use. These patients received 3581 cycles of chemotherapy (Paclitaxel, Docetaxel, Gemcitabine, Vinorelbine, Doxorubicin). The total cost for these treatments were US$ 5 364 000. If C replaced 100% of the IV CHEMO, the total cost would drop to US$2,078,000, 62% smaller than the IV alternative. In a simulation, where 60% of the patients would use the IV option and 40% would use C, the total cost would also be smaller: US$4,050,000, 25% smaller than when IV route is used exclusively. CONCLUSIONS: The adoption of C by HI in Brazil is cost-saving for BC patients.