OBJECTIVES: Several platinum-based combination therapies can be used for the treatment of non-small lung cancer. According to a recent review, there is no clearly superior treatment in terms of effectiveness, the objective of our current study was to determine whether treatment with oral vinorelbine plus cisplatin can be potentially cost saving for payers, compared to treatment with pemetrexed and cisplatin. METHODS: Considering the similar efficacy results of both treatment options in non-squamous non-small cell lung cancer patients (NS-NSCLC), as reported in a randomized phase II study (NAVoTRIAL01), a cost minimization analysis was conducted across 12 European countries (Austria, Czech republic, Denmark, Finland, France, Germany, Greece, Norway, Slovak Republic, Spain, Switzerland, the UK). This analysis adopted the perspective of the National Health Service. Costs considered were those related to anticancer drugs, administration settings (i.e. out-patient/in-patient/at home), serious adverse events and concomitant medications. All relevant costs were calculated based on country-specific reimbursement procedures and official tariffs. RESULTS: : Using the perspective of the National Health Service, the savings per patient treated with oral vinorelbine ranged from €1,317 in Denmark to €35,001 in Germany. Expressed as a percentage, it varies from 5% (France) to 83% (Czech Republic). Pooled average costs for each treatment option across the 12 countries resulted in an estimated cost saving of €12,871 per patient favouring treatment with oral vinorelbine plus cisplatin as opposed to treatment with pemetrexed plus cisplatin. Sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: This pan-European economic analysis provides economic evidence to support the use of oral vinorelbine instead of pemetrexed in the treatment of NS-NSCLC. Indeed, oral vinorelbine provides similar efficacy and an easily manageable safety profile at a lower overall cost per patient treated (from the perspective of the NHS). These benefits are also supported by a convenient mode of administration for the patient.