OBJECTIVES: The purpose of this study was to compare the cost of the oral therapy with capecitabine + IV cisplatin (XP) against standard IV therapy with 5-fluoruracil + cisplatin (FP) as first-line treatment for patients with advanced gastric cancer (AGC). METHODS: A cost minimization analysis was conducted based on clinical data from the phase III trial of Kang et al. 2006. In this trial patients were treated until disease progression, which corresponded to 5.22 cycles of chemotherapy for XP and 4.56 cycles for FP (Kang et al. 2006). Progression free-survival and overall survival with XP was non-inferior to FP. Therefore, we assumed that both treatments compared in this study had the same effectiveness. We considered direct costs (drugs, administration of drug, physician fees), non-medical direct costs per patient (transportation to hospital) and indirect costs (hours of absence from work). A Delphi panel was conducted to identify local practices and resources use in Brazil. Costs such as medical payment, pre and post medication and administration were also included. One-way and multi-way sensitivity analyses were performed for testing robustness of results. RESULTS: Total cost per patient in the XP group (R$ 14,247) was significantly lower than the total cost per patient in the FP group (R$ 15,649). As a result of the additional visits for infusion of 5-FU, FP patients incurred greater indirect costs in terms of lost time. The sensitivity analysis confirmed the robustness of the results. Capecitabine benefits AGC patients by reducing the number of infusion visits and time spent receiving IV administration, and would produce significant direct medical cost savings. CONCLUSION: Findings of this cost-minimization analysis suggest XP as a cost-saving alternative from the Brazilian societal perspective.