OBJECTIVES: Data on economic burden of advanced or metastatic non-small cell lung cancer (NSCLC) are lacking in Slovakia. Therefore, the objective of this cost of illness study was to measure the resource utilisation and the costs associated with treating advanced or metastatic NSCLC in Slovakia and provide a basis for cost-effectiveness evaluations. METHODS: The project was run in two phases: in the first phase an Expert panel took part in the survey and developed the diagnostic and treatment algorithms to reflect the local medical practice and quantify the use of resources associated with anticancer drug treatment, management of adverse events and best supportive care. Then, in the second step, 2012 management costs were applied to the resources. All types of health care used in the NSCLC management were evaluated (outpatient and inpatient visits, diagnostics, prescription drugs and examinations). The analysis was performed from the Slovakian health insurance perspective reflecting direct medical costs only. The structure of cost data follows the requirements of pharmaco-economic modelling in NSCLC. RESULTS: Monthly costs of advanced or metastatic NSCLC management during the active treatment (before progression) count for €1055.67, during the disease progression €1101.21 and on the best supporting care €1561.22. The most frequent regimens were cisplatin+gemcitabine (20.6%) and cisplatine+pemetrexed (19.1%) in the first line, erlotinib (49.1%) in the second line and gemcitabine (29.6%) in the third line. The most costly side effects were renal toxicity (€1060.85), febrile neutropenia (€902.92), hemoptysis (€717.08), anaemia (€668.84), pain (€631.34), leukopenia/neutropenia (€629.58), dyspnoe (€628.35), thrombocytopenia (€578.60), nausea/vomiting (€562.72) and fatigue (€523.19). CONCLUSIONS: Cost-effectiveness must be demonstrated in order to get reimbursement in Slovakia and local resource use data are key drivers for health economic modelling and can guide resource allocation decisions in NSCLC. This study provides important information to support these decisions.