There are three licensed alternatives for managing advanced breast cancer (ABC) patients in the UK, but they have not been directly compared in clinical studies. OBJECTIVE: To capture the costs and quality of life (QOL) related outcomes for ABC patients managed with docetaxel (DOC) in comparison to vinorelbine (VIN) and paclitaxel (PAC). METHODS: An updated version of the Hutton et al. (Pharmacoeconomics 9 Suppl 2, 1996) model was used to simulate the experiences (associated costs and outcomes) of patients undergoing treatment for ABC, from the onset of salvage chemotherapy to death. Published clinical trials were used to establish response rate, time to progression, median survival, rate of grade four febrile neutropenia, and toxicity rate related to chemotherapeutic agent. QOL utility scores were obtained from oncology nurses. Costs were taken from published sources and reflect the UK National Health Service and were discounted at 6%. RESULTS: The average patient costs were 4268 for VIN, 7817 for DOC and 7645 for PAC. The estimated Quality Adjusted Life Year (QALY) values were 0.48 for VIN, 0.73 for DOC and 0.65 for PAC; an additional 91 days of good quality life for DOC versus VIN and an additional 29 days of good quality life versus PAC. The incremental cost per QALY for DOC were 14,500 compared with VIN and 1,990 compared with PAC. Various sensitivity analyses were undertaken and did not greatly change the findings. The cost-effectiveness ratios are within the range of generally acceptable technologies. CONCLUSION: Patients managed with DOC have improved QOL in comparison to these alternative chemotherapies and a longer median survival.