OBJECTIVES: Previous real world data from 2013 showed the patterns of care of first-line NSCLC treatment in the Brazilian supplementary health system: carboplatin with pemetrexed (29.7%), bevacizumab containing regimens (20.8%) and oral chemotherapy (6%). The same study reported the average cost of management of this patients as 19.001,79USD. However, treatment patterns and cost of illness may have changed after enacting of a federal law (number 12880/2013) that has established the mandatory coverage of oral chemotherapy by the supplementary system. Therefore, the aim of this analysis was to evaluate the impact of oral chemotherapy incorporation in the patterns of care and  cost of illness of first-line NSCLC treatment in Brazil.  METHODS: All metastatic NSCLC patients receiving first-line treatment during 2014 were eligible and retrieved from the private market administrative claims database (Evidencias- Kantar Health database). Patterns of care were evaluated and compared before and after introduction of law 12880/2013. The cost of illness was calculated by a bottom-up approach. Exams, fees, and associated drugs reported were also considered for costing and values were derived from Tables Simpro and CBHPM. Exchange rate used was 1.00USD = 2.20BRL. RESULTS: We studied 110 patients with first-line  NSCLC and found 19 different chemotherapy regimens. We observed few changes in the patterns of care: carboplatin with premetrexed is still the most used (32,7%), followed now by carboplatin with paclitaxel (19,1%) and bevacizumab containing regimen (16,4%). Oral chemotherapy represented 9,1% of the regimens. Costs of schemes ranged from 4,963.75USD to 52,374.55USD and the calculated average cost of management of one patient is 23,725.76USD.  Additionally, there was a significant increase in the number PET CT required, from 28% in 2013 to 48% in 2014. CONCLUSIONS: We observed a low impact of oral chemotherapy incorporation in the patterns of care and cost of illness of first-line  NSCLC treatment.