OBJECTIVES: Chemotherapy-induced nausea and vomiting (CINV) remains a major adverse effect of cancer therapy. We aimed to determine outcomes and cost-effectiveness associated with use of aprepitant in patients undergoing cisplatin based chemotherapy in Hungary from a patient's and payer's perspective. METHODS: A global decision-analytic model was adapted in Hungary which compared an aprepitant regimen (aprepitant/ondansetron/dexamethasone) to a control regimen (ondansetron/dexamethasone) over a five days period. Clinical results observed in aprepitant phase III clinical trials, and utility data came from published literature were assingned Hungarian resource utilisation and unit cost data. RESULTS: Complete responders over one chemotherapy cycle was observed in 71.9% of patients in the aprepitant group compared to 59.9% of patients in the control group. Total cost per patient in aprepitant and control group was €259 and €254 restrospectively. As the result of cost-effectiveness analyses was practically cost neutral; the incremental cost per additional responder was irrelevant (€5). Patients were estimated to have gained an equivalent of 8,25 additional hour of perfect health per three cycle (0,34 quality-adjusted life days) with aprepitant-based regimen compared to control regimen. Cost per quality-adjusted life year gained with aprepitant was estimated at €5363. CONCLUSIONS: Aprepitant-based strategy is more effective in CINV-related health outcomes in patients undergoing highly emetogenic chemotherapy. Incremental benefits materialised in a cost-effective fashion.