OBJECTIVES: To identify which is the chemotherapy scheme alternative that minimizes costs in the 1st line treatment of Metastatic Colorectal Cancer (mCRC) in Mexico METHODS: Cost minimization comparing different chemotherapy schemes for mCRC: XELOX (Capecitabine+Oxaliplatin), FOLFOX-4 (Oxaliplatin+Fluorouracil+folinic acid), FOLFOX-6 (Oxaliplatin+ Fluorouracil+ folinic acid) and FOLFIRI (Irinotecan+Fluorouracil+folinic acid). It was performed a Markov model with 3 stages: disease progression, disease free progression and death in a time horizon of 3 years. Costs were based on direct medical costs of the institution, drug administration costs and cost for the management of adverse events and they are expressed in US dollars. RESULTS: The average treatment cost for the alternatives were: $ 16,133.78 for XELOX, $ 25,690.58 for FOLFOX-4, $ 27,686.35 for FOLFOX-6 and $ 21,904.12 for FOLFIRI. XELOX is the least costly alternative. The difference in costs is mainly due to the difference in management costs and the presence of grade 3-4 adverse events, mainly neutropenia. Based on clinical trials, FOLFOX-6 presented neutropenia (47%), FOLFOX-4 (44%) and FOLFIRI (26%), while the most severe adverse event was diarrhea with XELOX (12%). In the disease management, FOLFOX-6, FOLOFX-4 and FOLFIRI require two hospitalizations per cycle for the application of the drug. Instead, XELOX requires only one chemotherapy session. Since Capecitabine is orally administered, not only minimizes the costs of administration, also has a better safety profile with less adverse events. CONCLUSIONS: The use of Capecitabine combined with Oxaliplatin scheme as first-line treatment of metastatic colorectal cancer, is the alternative that minimizes costs to the health institutions, as well as improve quality of life resulting from Capecitabine’s oral administration.