OBJECTIVES: Chemotherapeutic drugs for mNSCLC patients are tested in “optimal conditions” in randomised control trials at prescribed dosing schedules. In clinical practice however, providers determine dosing schedules according to physician expertise, patient indication, institution guidelines and cultivated practice. Regional authorities reimburse chemotherapeutics according to different tariffs and codes. METHODS: A systematic literature review of the bibliographic databases Medline and Embase was performed. In addition, hand searching of reimbursement databases, national reimbursement tariffs and semi-structured interviews with expert oncologists were completed. Data extraction and evidence synthesis from these sources formed the basis for this evaluation. RESULTS: Fifty-nine publications (16 manuscripts, 29 study protocols, 14 EMEA Public Assessment Reports) and nine expert interviews across four countries were included. The eight mNSCLC drugs and their seven combinations result in a wide set of administration patterns with variation in treatment schedules, number of interventions per patient, and difference in treatment settings in terms of inpatient versus outpatient approaches. Calculation of the 6 monthly administration cost of seven drug regimes for mNSCLC in France, Germany and Spain results in a range of €2,970 to €19,792, most affected by inpatient or outpatient administration setting. CONCLUSIONS: The following factors were found to result in variations in administration costs: setting (i.e. inpatient/outpatient); frequency of administration (e.g. weekly); duration of single administration (10 – 120 minutes); length of cycle (total number of administrations) type of cycle length (fixed or flexible); health care professional administering (e.g. nurse or physician); concomitant drugs (e.g. saline) and drug dosage. Together with differences in country-specific reimbursement tariffs, these factors create significant variation in administration patterns and costs associated with the delivery of drugs for mNSCLC.