OBJECTIVES: Lung cancer (LC) is one of the major health problems due its high mortality. The most common type of LC is non-small cell lung cancer (NSCLC), which accounts for approximately 80% of all LC cases; approximately 3%-5% of these have a gene defect called ALK (anaplastic lymphoma kinase). The aim of this study was to evaluate the budgetary impact of adding crizotinib for patients with ALK-positive advanced NSCLC in Colombia. METHODS: A budget-impact model was developed to evaluate crizotinib from the payer perspective. Comparators were: crizotinib (250mg bid), erlotinib (150mg/day), bevacizumab/platinum doublet (15mg/kg / Carboplatin AUC6+Paclitaxel 200mg/m2 per cycle [28 days]), paclitaxel/platinum (Carboplatin AUC6+Paclitaxel 200mg/m2 per cycle), docetaxel/platinum (Cisplatin 75mg/m2 + Docetaxel 75mg/m2 per cycle), pemetrexed/platinum (Carboplatin AUC6+Pemetrexed 500mg/m2 per cycle), gemcitabine/platinum (Cisplatin 75mg/m2 day1+Gemcitabine 2,500mg/m2per cycle). Two scenarios were compared: (1) no tested patients, excluding crizotinib (2) all patients tested with FISH (diagnostic test) to identify ALK-positive NSCLC patients; it was taken into account a positive match for ALK of 4.2% and only 3% receiving crizotinib. Epidemiology and acquisition, administration and adverse events costs were estimated from Colombian sources, values are expressed in 2012 US$. RESULTS: Considering Colombian population >18 years (incident rate of LC 0.018%, proportion NSCLC 87.86% and advanced NSCLC 52.29%), it was estimated a cohort of 4768 advanced NSCLC patients, overall 1-year costs of treating patients with NSCLC would be US$197,929,584 with crizotinib, compared with US$190,725,844 without crizotinib. Acquisition costs of crizotinib were offset by reductions in adverse events (AE) costs (anemia, anorexia, asthenia, diarrhea, dyspnea, fatigue, neutropenia, neutropenic infection, nausea, vomiting, pulmonary events,). Administration costs accounted between 37.77%-38.16% of total costs, while AE management costs made up 1.19% to 1.27% of total costs. CONCLUSIONS: Treating ALK-positive advanced NSCLC patients with crizotinib, leads to a decrease in total costs of managing adverse events (US$65,042) and progression costs.