OBJECTIVES: This analysis compares the cost effectiveness (CE) of an induction and maintenance sequence of a cisplatin plus pemetrexed (cis+pem) doublet followed by pemetrexed, with that of a bevacizumab (7.5mg or 15mg) plus cisplatin plus gemcitabine (bev+cis+gem) triplet followed by bevacizumab (7.5mg or 15mg) for the treatment of non-squamous non-small cell lung cancer (NSCLC) in Sweden.    METHODS: As no head-to-head trial data are available comparing these relevant regimens in the first-line induction and maintenance treatment settings, decision modelling and evidence synthesis were used to estimate CE. A series of network meta-analyses were performed to obtain hazard ratios for overall survival (OS) and progression-free survival (PFS) for each induction and maintenance comparator, and odds ratios for response for induction comparators. Bevacizumab doses were pooled in the meta-analyses. The CE model was structured using an area-under-the-curve approach. Costs and benefits were discounted at 3% per annum, consistent with Swedish practice. RESULTS: Cis+pem induction followed by pemetrexed maintenance was associated with a higher median PFS, OS, total life-years gained and quality-adjusted life-years (QALYs) than the bevacizumab triplets. Total costs were  416,478Kr for the bev(7.5mg)+cis+gem induction triplet plus bevacizumab 7.5mg maintenance sequence, 478,862Kr for the cis+pem doublet followed by pemetrexed maintenance sequence, and 541,677Kr for the bev(15mg)+cis+gem induction triplet followed by bevacizumab 15mg maintenance sequence. Total QALYs were 0.73 and 0.97 for the bevacizumab triplets and pemetrexed induction and maintenance sequence. The incremental cost-effectiveness ratio (ICER) of cis+pem followed by pemetrexed compared with bev(7.5mg)+cis+gem followed by bevacizumab 7.5mg was 260,831Kr (30,477Euro). The higher bevacizumab dose of 15mg was dominated by the cis+pem followed by pemetrexed sequence. The results of the probabilistic analysis support these results. CONCLUSIONS: The results of the CE analysis suggest that cis+pem doublet induction followed by pemetrexed maintenance is a cost-effective treatment sequence compared with the bevacizumab options for NSCLC in Sweden.