OBJECTIVES: The purpose of this model is to examine the budgetary impact of the decision to reimburse crizotinib for patients with ALK+ve advanced non-small-cell lung cancer (NSCLC). METHODS: A Markov Model was developed to evaluate the disease progression of a cohort of patients with ALK +ve advanced NSCLC in a three year period, that will be treated with Crizotinib. The model compares scenarios with and Without Crizotinib. The difference in total costs is the net impact of Crizotinib on the health care budget. Local epidemiologic data was used. Costs were estimated from Panama Public Health System ($US, 2012) and included costs of   treatment, administration and monitoring, palliative care, and severe adverse events. The base case scenario assumes 100% testing rate for ALK in incident patients and 100% market share for crizotinib in ALK+Ve advanced NSCLC patients. Sensitivity analyses were performed for 80-100% market share. RESULTS: In a three year period, 23 patients received Crizotinib (from a cohort of 609 advanced NSCLC patients). Cost related to drug acquisition in a world “With” and “Without” Crizotinib during three years are $13.525.223  and $12.474.988 respectively which represents $1.050.235 of budget impact associated with the insertion of Crizotinib in the market, however it shows savings in terms of drug administration, monitoring and management of adverse events costs and progression cost, with an estimated of $152.876 (Difference between the two scenarios of $4.446.024 and $4.598.900). Net budget Impact for the three year period is $897.359, which represents for the first year ($194.182, $0.0072  per patient-per month [PMPM]) approximately 0.00398% of Panama’s Total Public Health Expenditure (2011). If the Crizotinib market share is assumed to be 80%, the net impact was $155.815. CONCLUSIONS: Crizotinib for the treatment of ALK+ NSCLC patients has a minimal incremental budget impact on the overall expenditure within the Panama Health System.