OBJECTIVES: To determine and compare the cost effectiveness of Bev+Pac+Car vs. Pem+Cis regimens in the treatment of patients with adenocarcinoma non-squamous NSCLC from a Polish Public Payer’s perspective. METHODS: Efficacy and safety of 15 mg of bevacizumab+200 mg/m2 of paclitaxel+6mg/ml/min of carboplatin vs. 500 mg/m2 of pemetrexed and 75 mg/m2 of cisplatin was assessed based on a systematic review performed for both therapies according to evidence-based medicine principles. A cost-effectiveness analysis was performed with a life time (5 years) horizon and the National Health Fund perspective. A three state (progression-free, progression, death) Markov model was developed. Costs of 1st and 2nd line therapy, administration and monitoring, adverse events treatment and palliative care were included. Sensitivity analyses testing the influence of length of time horizon, probability of progression, utilities, discounting rates, cisplatin dose, the length and costs of 2nd line therapy were performed. RESULTS: Bev+Pac+Car results in 0.21 life years gained per patient when compared to Pem+Cis in the treatment of patients with adenocarcinoma non-squamous NSCLC. The additional cost per patient was 18,840 pln (1 EURO=4.1PLN) over patient’s lifetime when Bev+Pac+Car was used instead of Pem+Cis regimen. The incremental cost-effectiveness ratio (ICER) was at an acceptable 91,216 pln. The sensitivity analyses demonstrated that the duration of 2nd line treatment (assumption of 2nd line treatment continuation for more than 6 cycles) considerably influenced the ICER (1,198 pln). Other sensitivity analyses confirmed the base case  results, proving conclusions’ robustness. CONCLUSIONS: Based on this modeling analysis 1st line Bev+Pac+Car therapy is a clinically superior and cost-effective treatment for patients with adenocarcinoma non-squamous NSCLC when compared to chemotherapies such as Pem+Cis.