OBJECTIVES : Five polychemotherapy regimens: gemcitabine-cisplatine (GC), vinorelbine-cisplatine (VC), docetaxel-cisplatine (DC), paclitaxel-cisplatine (PC) and paclitaxel-carboplatine (PCa), are commonly used in first-line treatment of advanced non-small cell lung cancer. Whereas taxanes have to be administered within a conventional day-hospitalization setting, gemcitabine and vinorelbine can be administrated in a home-care setting. The purpose of the study is to find out which case management minimizes costs for the French National Health Insurance while ensuring patient safety. METHODS : A Markov model was constructed in order to estimate the cost consequences of home administrations for gemcitabine and vinorelbine chemotherapies without cisplatine compared to taxanes administrated only at hospitals. Transitional probabilities are based on Scagliotti (2002), Fossela (2002), Smit (2003), published randomized trials. In all cases, no differences in efficacy were found between regimens. A cost-minimization analysis was performed. The costs of treatments were calculated by adding DRG costs, onerous drug reimbursed over DRGs, and transportation expenses. Costs of severe toxicities, diagnosis and palliative care are taken into account. RESULTS : With the conservative hypothesis of non-different therapeutic efficacy and no more than two administrations at home per cycle, GC and VC appear with annual follow-up costs of 7,315 € [7,064-7,570] and 7,686 € [7,378-7,997]. Administrated within a conventional day-hospitalization, their annual follow-up costs are of 8,103 and 9,605 €, respectively. Taxanes DC, PC and PCa at hospital have annual follow-up costs of 8,778 € [8,185-9,108], 9,068 € [8,367-9,446], and 10,140 € [9,436-10,510]. To obtain the same overall costs between GC and DC, the acquisition cost of gemcitabine has to be multiplied by 50%. CONCLUSION: According to the national guidelines on chemotherapy home care infusion, the choice of extrahospital treatment in case of equivalent efficacy has a better efficiency from the French National Health Insurance's perspective.