OBJECTIVES: The effect of having a positive anaplastic lymphoma receptor tyrosine kinase (ALK) mutation on the burden of disease in Stage IV non-small cell lung cancer (NSCLC) is unknown. This study compared the burden of disease in ALK positive Stage IV NSCLC with ALK negative Stage IV NSCLC. METHODS: Burden of disease by ALK mutation status was evaluated in Egypt, Russia, and the United Arab Emirates (UAE) using disability adjusted life years (DALYs). A burden of disease model was developed in line with World Health Organisation (WHO) guidelines. Epidemiological data were collected by a survey disseminated during interviews in at least three centres per country. Disability weights were obtained from a Dutch study. Discounting, age-weighting and life expectancies were based on the WHO reference case. Sensitivity analyses were conducted to test the level of uncertainty in the model results. RESULTS: Total DALYs across the countries were lower in ALK positive disease compared to ALK negative disease (833 vs. 2611). On a per country basis, total DALYs were higher in ALK positive disease compared to ALK negative disease for Egypt (22 vs. 11) and UAE (229 vs. 219) but lower for Russia (582 vs. 2381). DALYs per incident case of the disease were consistently higher across the countries in ALK positive disease compared to ALK negative disease (Egypt: 11.24 vs. 10.85; Russia: 9.38 vs. 4.97; UAE: 15.29 vs. 7.82). Results were sensitive to changes in discounting, age-weighting, deaths, and incidences. CONCLUSIONS: The study would suggest that the greatest burden of disease lies in the population with ALK negative Stage IV NSCLC compared to ALK positive Stage IV NSCLC, although this finding varied between countries. However, it was consistently found that a single patient with Stage IV NSCLC will have a greater burden of disease if their ALK mutation test is positive.