Abstract: OBJECTIVE to provide reference for clinical decision making by cost-utility analysis to conduct on three antiemetic regimens from a Chinese social medical perspective, namely the aprepitant+palonosetron+dexamethasone triple regimen(APD), the aprepitant+palonosetron+dexamethasone+olanzapine quadruple regimen(APDO) and the triple regimen of netupitant/palonosetron capsule+dexamethasonetriple regimens(NPD). METHODS Decision tree model was established with incremental cost-utility ratio(ICUR) as the analysis index and 2020 Chinese gross domestic product per capita ￥72 000/quality-adjusted life year(QALY) was used as willingness-to-pay(WTP) to compare the cost-utility of APD, APDO and NPD regimens in China, a series of sensitivity analyses were conducted to assess the stability of the model. RESULTS From the Chinese social medical perspective, for cancer patients receiving highly emetogenic chemotherapy, compared with APD regimen, APDO and NPD regimen yielded ICURs of ￥48 400.97/QALY and ￥46 755.56/QALY, respectively, which were lower than the WTP, thus APDO and NPD regimens were cost-utility and NPD regimen had better cost-utility. The results of sensitivity analyses showed the model was stable. CONCLUSION Among the APD, APDO and NPD regimens, the NPD regimen is the most economical for cancer patients receiving highly emetogenic chemotherapy in China.