Objective   This study evaluated the economical effects of two different regimens for metastatic breast cancer, namely, paclitaxel plus either carboplatin (TP) or epirubicin (TE).

  Methods   The cost-effectiveness method in pharmacoeconomics was adopted to analyze retrospectively the two different regimens.

  Results   The median follow up was 23.5 (range: 9 to 42) months. The overall response rate for TP and TE were 78.33% and 80.00%, respectively. The 1- and 2-year progression-free survival rates of TP and TE were 43.6% and 38.9% and 10.8% and 17.4%, respectively. The 1- and 2-year overall survival rates were 80.3% and 78.3%, respectively for TP, whereas the corresponding values for TE were 53.2% and 47.9%. No statistically significant difference was found between the two groups (P>0.05). Cost-effectiveness analysis showed that the average costs of the TP and TE regimens were 10 303.8 and 13 853.3 yuan, respectively, with corresponding cost-effectiveness ratios of 131.54 and 173.17 (P < 0.01). For the chemotherapy toxicity, the alopecia reactions of the TP group were significantly lower than those of the TE group (P < 0.01).

  Conclusion   The short- and long-term efficacies of the two regimens were similar. TP regimen was the optimal scheme for advanced metastatic breast cancer.