OBJECTIVES:  To estimate the budget impact of comprehensive genomic profiling that interrogates the entire coding sequence of 315 cancer-related genes plus select introns from 28 genes to identify targeted treatment in patients with advanced lung carcinoma in Europe. METHODS:  A 5 year budget impact model was developed to determine the financial implications of incorporating genomic profiling of biopsy samples in patients with advanced lung carcinoma. Costs included testing and associated costs and treatment costs. Testing results were obtained from in house data and also literature, costs were identified from technology assessment reports and literature. Sensitivity analyses were conducted on proportion of testing and costs. Results are compared with a mix of current testing including Polymerase Chain Reaction (PCR), Fluorescence in situ Hybridisation (FISH) and no testing. RESULTS:  The incremental budget impact varied from between €0.20 to €0.80 per person within a population dependant on mix of type of testing and cost of drug treatments. Total budget impact (per person cost x population) was country dependant, for the UK the result was between £12.75 million and £42 million after 5 years. CONCLUSIONS:  Comprehensive genetic profiling may be an affordable option to identify the most appropriate targeted therapy for an individual patient. Further research is warranted on the potential gain in survival outcomes when treatment is optimised. Furthermore health systems may need to move from a tumour type based treatment approach to a mutation specific based indication as recommended therapies may be approved for another tumour type and not the one tested.