OBJECTIVES: To identify which of the different chemotherapy alternatives minimizes costs for the treatment of advanced and/or metastatic Gastric Cancer (GC) in Mexico. METHODS: A cost minimization was performed considering the alternatives: EOX (epirubicin+oxaliplatin+capecitabine), EOF (epirubicin+oxaliplatin+fluorouracil), ECX (epirubicin+cisplatin+capecitabine) and ECF (epirubicin+cisplatin+fluorouracil) for the treatment of advanced and/or metastatic gastric cancer (advGA) using a Markov model with 3 stages: progression, disease free progression and death. For a time horizon of 3 years, it was taken into account direct medical costs for the disease management, drug and its application cost, and costs incurred in the management of the associated adverse events. Costs are expressed in USD dollars. RESULTS: ECX was the alternative with less costs ($6,293), followed by EOX ($7,692). The chemotherapy combinations based on capecitabine proved to be the least expensive. The alternative EOF had a cost of $10,904, while ECF was $9,873. The factor that increased costs of EOF and ECF was the drug administration costs, as they require to be administered as daily intravenous infusions in comparison of the oral administration of capecitabine. Therefore, the administration costs of ECX and EOX represent only 4.76% of the administration costs of ECF and EOF. The results of the univariate sensitivity analysis confirmed savings with capecitabine versus ECF from $5,721 to $6,209 and versus EOF from $5,691 to $6,178 in the total management costs. The probabilistic analysis results also confirmed that in the ECF scheme versus ECX, the combination with capecitabine is a cost-saving alternative. ECX and EOX are alternatives that minimize costs at 100% of cases compared to ECF and EOX respectively. CONCLUSIONS: The oral administration of capecitabine is the factor that minimizes the cost of the alternatives in the chemotherapy combination schemes, also, the safety profile of capecitabine helps incurring in less costs associated to the management of side adverse events.