OBJECTIVES: Paclitaxel and docetaxel are used for the treatment of MBC in China.  However, one important drawback, particularly with docetaxel, is the potential for dose-limiting toxicity.  To improve the side effect profile and efficacy of paclitaxel, an albumin-bound formulation (nab-paclitaxel) is currently available in China (Abraxane^®).  Clinical trials have demonstrated that nab-paclitaxel is safer and more effective than both docetaxel and paclitaxel.  To provide economic data for China, a cost utility analysis comparing nab-paclitaxel to docetaxel, both as alternatives to paclitaxel was conducted. METHODS: Clinical data was obtained from a meta analysis of randomized trials comparing either nab-paclitaxel (260 mg/m q3wk) or branded docetaxel (100 mg/m q3wk) to solvent-based branded paclitaxel (175 mg/m q3wk). Health care resource use for the delivery of chemotherapy and the management of grade 3/4 toxicity was collected from a time and motion study in three Chinese cancer centers and from a survey of clinicians.  Using the Time Trade-off technique, treatment preferences and utility estimates were obtained from interviewing 28 cancer patients from two centres in China.  All costs were reported in 2014 $U.S. RESULTS: Nab-paclitaxel had the most favourable safety profile characterized with the lowest incidence of grade 3/4 neutropenia, febrile neutropenia, anemia and stomatitis.  This translated into lower costs for managing the grade 3/4 side effects of nab-paclitaxel relative to both docetaxel and paclitaxel ($21 vs. $166 vs. $81). In the preference assessment, 22 of 28 (78.6%) patients selected nab-paclitaxel as their preferred agent.  As an alternative to paclitaxel, the cost per quality adjusted life year (QALY) gained was more favourable with nab-paclitaxel than docetaxel ($57,900 vs. $130,600 respectively). CONCLUSIONS: Nab-paclitaxel is an economically attractive alternative to paclitaxel and docetaxel in MBC, providing a substantially lower cost per QALY. Additionally in the patient preference survey, 78.6% of patients selected nab-paclitaxel as their preferred agent.