OBJECTIVES: Novel treatment options for NSCLC patients were shown to improve survival outcomes. Thus it is of interest whether published evidence can be found on work productivity and employment consequences for this patient group and their informal caregivers, and on respective indirect cost data. METHODS: A systematic literature search from 1990 onwards was performed using 19 bibliographic databases available via DIMDI (German Institute of Medical Documentation and Information), supplemented by searches for other publicly available sources such as abstracts at major health economic and clinical conferences, HTAs and further grey literature. RESULTS: So far published indirect cost data are elusive and rather limited to overall lung cancer. In lung cancer, indirect cost accounted for the major portion of total estimated cost, e.g. for Germany 78% (Ruff, 2000) to 89% (Weißflog, 2001). Indirect costs per case seem to increase with stage. In an Australian study overall stage IV lung cancer patients had direct and indirect costs that were 19% higher than the average (Bishop, 2009). The only indirect cost information on advanced NSCLC was reported by Romanus (2008) for the US (mean wage loss per newly diagnosed end stage IV NSCLC patient was $1697 [$126-$3371] in the first few months after diagnosis) and by Perrone (2004) for Italy (mean productivity loss per patient of €60,263). Employment rates of NSCLC patients were reported to be about 13% of NSCLC stage IIIb or IV, treated with 2nd line chemotherapy in Italy (Gridelli, 2007). In the same population the informal care given by the principal caregiver was the main assistance cost item with average 3-month cost of €2368 representing 74% of total assistance cost. CONCLUSIONS: The indirect cost burden of NSCLC has scarcely been assessed so far and needs further quantitative investigation, particularly in view of the use of new treatment options.