OBJECTIVES: :To describe treatment patterns/costs for patients with stage IV NSCLC in Italy. METHODS: Retrospective database analyses were conducted for 3 Local Health Units (LHUs) from 3 separate regions: Veneto, Tuscany and Lombardy. Resource use/costs were estimated from administrative databases provided by the LHUs from Tuscany and Lombardy, and chemotherapy regimens from hospital electronic medical records (EMR) provided by the LHU from Veneto. RESULTS: A total of 306 patients were enrolled: 248 (81.0%) non-squamous (non-sq) NSCLC, 58 (19.0%) squamous (sq) NSCLC. For the non-sqNSCLC and sqNSCLC patients, respectively, the average age was 66.9, 68.8 years, 64.1%, 81.0% were male, the most common co-morbidities were cardiovascular disease: 34.3%, 48.3% and metabolic disorders: 12.9%, 20.7%. Among non-sqNSCLC patients, 193/248 (77.8%) received chemotherapy. In the LHU from Veneto, the most common first-line therapy was pemetrexed+platinum (42/93 (45.2%) patients). 46/93 (49.5%) received second line treatment. Erlotinib was most commonly used (23/46 patients). Among sqNSCLC patients, 46/58 (79.3%) received chemotherapy. In Veneto, the most common first-line therapy was a gemcitabine+platinum (18/23 (78.3%) patients). 9/23 (39.1%) received second line treatment. Docetaxel monotherapy was most commonly used (7/9 patients). 106/124 (Tuscany and Lombardy) non-sqNSCLC patients (85.5%) had a NSCLC inpatient hospitalisation. Mean number of inpatient days was 34.0 days per patient. Total health care cost related to the first line of chemotherapy was €7,435 of which €3,812 was for NSCLC hospitalisations. 21/28 (Tuscany and Lombardy) sqNSCLC patients (75.0%) had a NSCLC inpatient hospitalization. Mean numbers of inpatient days was 29.2 days per patient. Total health care cost related to the first line of chemotherapy was €5,257 of which €3,716 was for NSCLC hospitalisations. CONCLUSIONS: :LHU databases provide an important means for assessing patient treatment patterns and resource use/costs and are encouraged to make their data available