OBJECTIVES: Crizotinib, a tyrosine kinase anaplastic lymphoma kinase (ALK) inhibitor, represents a therapeutic alternative to patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) that are ALK+. This study aimed to estimate the cost-effectiveness of crizotinib in the treatment of this group of patients compared to currently available chemotherapy schemes: gemcitabine+cisplatin (GC), pemetrexed+cisplatin (PC) and docetaxel+cisplatin (DC), from the Mexican public payer’s perspective. METHODS: A mutually exclusive, four-state Markov model was developed: stable without progression, stable with response to treatment, disease progression and death (monthly transitions, six-year timeframe, 5% discount rate). The model assess life-years gained and direct medical costs (pre-treatment, drugs costs, drug administration, monitoring and adverse event management), per each treatment (basecase GC), in terms of ICER. Effectiveness data was extracted from published literature. Drug costs and medical resources were extracted from Instituto Mexicano del Seguro Social database. Crizotinib’s cost were provided by manufacturer (not listed yet in Mexican formulary) and are expressed in 2012 US$. Univariate sensitivity analyses regarding monthly acquisition cost and clinical efficacy of crizotinib were performed.  RESULTS: Crizotinib was the most effective alternative with 3.02 life-years gained, compared with 1.55, 1.74 and 1.34 for GC, PC and DC, respectively. The cost of GC was $15,792.3, while the incremental cost for PC, DC and crizotinib were $10,787.4, $13,171 and $61,895.3, respectively. DC was dominated, while ICER for PC and crizotinib were $56,775.9 and $42,105.6, respectively, being crizotinib  a cost-effective alternative. Results were sensible to changes in acquisition cost of crizotinib and less sensible to changes in the probabilities of death and disease progression with crizotinib. CONCLUSIONS: From the Mexican public payer’s perspective, crizotinib would represent an opportunity for both, this group of patients, and health care institutions to achieve better clinical results than GC, PC and DC, as well as minor cost regarding PC.