OBJECTIVES: Bevacizumab is approved in metastatic non-small cell lung cancer and is currently tested in adjuvant lung cancer trials. In this context we explore the potential costs and health benefits of adding bevacizumab to a cisplatin-based adjuvant treatment regimen for stage IIa-IIIb patients with NSCLC and completely resected lung tumors. METHODS: A four health state Markov Model was used to explore the effects of adding 1 year adjuvant treatment with bevacizumab to an existing cisplatin-based treatment regimen. Baseline survival and relapse risks for cisplatin-treated patients are based on published data (IALT, International Adjuvant Lung Trial). The model uses a time-dependent risk of relapse up until six years after surgery as well as life-long time dependent risk of death. The effect of bevacizumab is included as a reduction in risk of relapse based on the expected hazard ratio (HR=0.79, FDA approved trial protocol).  The effect of bevacizumab is assumed to be constant for five years after surgery.Outcomes include number of relapses, life years, QALYs, direct costs (£), and incremental cost-effectiveness ratios. A life time horizon is used as the mean population age at surgery is 60 years. Cost and outcomes are discounted with 3.5% per annum. Sensitivity analysis is performed as probabilistic and deterministic sensitivity analysis.RESULTS: The mean undiscounted life expectancy for cisplatin-based chemotherapy treated patients was estimated to be 10.3 years (7.4 years discounted). The addition of bevacizumab is estimated to be increased to 11.9 years (8.4 years discounted). The discounted incremental cost-effectiveness ratio is £39,600/QALY gained.Sensitivity analysis on key variables show that assumptions on size of risk reduction, duration of risk reduction as well as baseline risk are the most critical factors for the ICER.  CONCLUSIONS: Adding bevacizumab to current cisplatin-based treatment regimens for early lung cancer is predicted to be a cost effective treatment option.