OBJECTIVE： To evaluate the economical efficiency of gemcitabine （G）， gemcitabine combined with oxaliplatin （GM）， gemcitabine combined with S-1 （GS） in the treatment of advanced pancreatic cancer （APC）. METHODS： From the perspective of patients， Markov model was constructed to calculate long-term cost and health outcomes of 3 chemotherapy regimens in Chinese APC patients aged 18-75 old. Cost-effectiveness analysis were used to determine the economic level according to willingness-to-pay （WTP）. The sensitivity analysis was conducted for cost， effectiveness and other indexes. RESULTS： The results of cost-effectiveness analysis showed that the cost effectiveness ratio （C/E） of G regimen in the treatment of advanced pancreatic cancer was 145 228.52 yuan/12.26 QALMs； C/E of the GM regimen was 154 783.88 yuan/11.39 QALMs； C/E of GS regimen was 315 485.28 yuan/23.26 QALMs； and the G regimen was the best option. The incremental cost-effectiveness （ICER） of GS and G regimen was 15 479.64， exceeded the WTP （12 563 yuan） set in this sutdy， while ICER of GM and G regimen was －10 999.89， and the GM regimen was absolutely inferior. Results of sensitivity analysis showed that ICER of G regimen vs. GM regimen was unstable and influenced greatly by the parameters of the model. Results of ICER analysis of G regimen vs. GS regimen and GM regimen vs. GS regimen kept stable. Compared to GS regimen， G regimen showed cost-effectiveness characteristics and GM regimen showed economic characteristics； the superiority was relatively less obvious. CONCLUSIONS： Within the level of WTP， cost-effectiveness analysis shows that gemcitabine is the optimal solution. However， sensitivity analysis result can not yet determine which scheme is the best one.