Few studies have investigated the cost-effectiveness of oral chemotherapeutic agents that are used to treat metastatic breast cancer (MBC) at home and in clinic settings. OBJECTIVE: This study assessed the value of MBC management using intravenous (IV) and oral chemotherapeutic agents. METHODS: A predictive data collection approach (modeling) was used to perform this cost-effectiveness analysis. Data were used from existing economic comparisons between home care and clinic care, from clinical trials, and using Medicare cost data in 1998 U.S. dollars. A societal perspective was used to compare the cost-effectiveness of the following 1st line chemotherapy regimens: C*MF (oral cyclophosphamide (C*), IV methotrexate (M), IV fluoruracil (F)), and AC (IV doxorubicin (A) and IV cyclophosphamide) at home and at an outpatient clinic; and the 2nd line regimens: IV paclitaxel (P), oral etoposide (E*), oral idarubicin (I*), and oral UFT (U*) at home and at an outpatient clinic. RESULTS: C*MF, administered at home, was the most cost-effective 1st line strategy (34,163 $/QALY). The home AC regimen was more costly, and more effective. It was not, however, cost-effective relative to the home C*MF strategy because the incremental-cost-effectiveness (ICE) between the two strategies was 1,763,990 $/QALY. E*, administered at home, was found to be the most cost-effective 2nd-line strategy (33,789 $/QALY). Other strategies (home P, clinic I*, and home I*) were more costly, but more effective. These strategies, however, were not cost-effective relative to home E* because the ICE between these strategies and E* were 945,101 $/QALY, 369,232 $/QALY, and 175,523 $/QALY, respectively. CONCLUSIONS: These results suggest that oral chemotherapeutic agents, administered at home, provide a cost-effective means of treating MBC.