OBJECTIVES: Combination chemotherapy is used to treat patients with metastatic lung cancer (MLC). As the benefits of these therapies are limited, cost is an essential consideration in this era of value-based medicine. While there have been previous studies which reported healthcare costs and utilization in MLC population, their methodology and sample greatly varied and most of them did not report lifetime costs. The objective of this study was to characterize utilization and cost of healthcare among MLC patients receiving chemotherapy in the US, from a third-party payer perspective. METHODS: A retrospective cohort design using a 10% random sample of the 2006 to 2015 IMS LifeLinkPlus claims dataset was employed to identify patients with MLC who received chemotherapy. The date of first MLC diagnosis was defined as the “metastatic cancer date.” An “index date” was defined as the date of first chemotherapy administration beginning anytime 45 days prior to the metastatic cancer date. Utilization and cost of healthcare services among MLC patients was analyzed over the enrollment period beginning with the index date, and ending with the date of disenrollment or end of study. The Kaplan-Meier Sample Average Method was use to estimate lifetime costs. RESULTS: N=2021 MLC patients met our inclusion/exclusion criteria. Majority were 55 years and older, and males (52%). The median follow-up was 273 days (approx. 8.9 MO). On average, patients experienced two inpatient hospitalizations with a mean length of stay of 7.5 days, 34.6 physician visits, 23.6 outpatient hospital visits and 45 prescriptions. The mean cumulative total healthcare cost was $144,795 (2015USD) per patient, with inpatient services and outpatient chemotherapy accounting for 25% and 32% of the total costs, respectively. CONCLUSIONS: Economic burden among MLC patients receiving chemotherapy still remains high with chemotherapy and outpatient care being the major cost drivers.