Abstract: OBJECTIVE To assess the cost-effectiveness of bevacizumab in combination with paclitaxel in HER-2 negative metastatic breast cancer(MBC) from a health service system perspective. METHODS Based on data from the efficacy and adverse events of the E2100 trial, a dynamic Markov model was used to simulate direct medical costs and quality-adjusted life years(QALYs) over the lifetime of patients. Incremental cost-effectiveness ratio(ICER) was used as an evaluation index to evaluate the advantages and disadvantages of bevacizumab combined with paclitaxel versus paclitaxel in the treatment of metastatic breast cancer, and the sensitivity of the results was analyzed. Health utilities were obtained from existing literature and costs were obtained from The Fourth Hospital of Hebei Medical University. RESULTS Bevacizumab combined with paclitaxel increased 0.28 QALYs compared with paclitaxel, and the cost increased 182 806 yuan, then ICER was 652 879 yuan/QALY, and the cost per additional one-year progression-free survival was 355 471 yuan. CONCLUSION Bevacizumab combined with paclitaxel can prolong the life years of HER-2 negative MBC patients, improve the quality of life, but also increase medical costs. According to the 3 times of GDP per capita judgment criteria of WHO, bevacizumab combined with paclitaxel for first-line treatment of HER-2 negative MBC has no cost-effectiveness advantage.