OBJECTIVES: Crizotinib, a first-in-class compound that specifically inhibits a tumor-specific protein called anaplastic lymphoma kinase (ALK) of non-small-cell lung cancer (NSCLC) is currently not reimbursable to all Thai patients. This budget impact analysis was aimed at examining the financial impact if crizotinib was subsidized for all identified ALK+ NSCLC patients in Thailand. METHODS: A 3-year budget impact model is designed to capture differences in outcomes related to the overall direct costs incurred from receiving crizotinib versus other standard therapies for 1^st, 2^nd and 3^rd lines of care. Local incidence of NSCLC and ALK+ rate were estimated from the national registry data and Chiang Mai University (CMU) Hospital data. The government procurement database was the reference for the drug cost. Other specific medical costs came from CMU Hospital. Cost attributable to prerequisite diagnostic testing was also incorporated into the model and testing strategies were created according to standard practice.   RESULTS: An estimated 5,377 new cases were diagnosed as advanced NSCLC annually and referred for further testing prior to receiving therapy. The net budget impact was estimated under two scenarios. In the first scenario where crizotinib was subsidized with no restriction, the average net budgetary impact in the 3-year period was 576 million baht (US$18 million) from the average 414 patients receiving crizotinib yearly. The second scenario in where crizotinib was restrictively used as 2^nd or 3^rd line, the average 3-year financial difference was 284 million baht (US$8.9 million) from the average 214 patients receiving crizotinib yearly. Univariate sensitivity analysis showed that crizotinib acquisition cost and prevalence of ALK+ were the leading parameters influencing the results of the first and second scenarios, respectively. CONCLUSIONS: This model captured the clinical and economic values of crizotinib for ALK+ NSCLC patients in Thailand. Nevertheless, humanistic value should be taken into account and still needs to be explored.