OBJECTIVES : NICE Guidance in 2001 recommanded vinorelbine, paclitaxel, and gemcitabine as part of first-line chemotherapy options for NSCLC patients. Since the Guidance was published, an oral formulation of vinorelbine and docetaxel have been introduced in UK. An Markov model has been developed to realise an indirect comparison of these five chemotherapies, and define their respective level of costs in the NHS' perspective. METHODS : Thirteen commonly used regimens including the oral form with an administration in d8 at home were defined by a panel of clinical oncologists. In absence of significant statistical difference between the principal criteria of effectiveness, a cost-minimization study was carried out by allocating to all comparators the published data for vinorelbine in Le Chevalier 1999. The corresponding unit costs of drugs, administration and toxicity management, patient transportation costs were gathered from BNF, PSSRU. The main cost incurring toxicities based on occurrence in referenced publications were taken into account. RESULTS : With the conservative assumption of no differences in therapeutic efficacy, the oral vinorelbine at a dose of 60 mg/m2/week, with one week of rest every 3 weeks, appears as the least expensive strategy : with an administration in d8 at home under a general practioner supervision, its annual follow-up cost is of £2,888 ; with an outpatient visit in d8, its annual cost is of £3,448. Administrated within a day-hospitalization, intravenous vinorelbine 25 mg/m2 d1 d8, gemcitabine 1,250 mg/m2 d1, d8, paclitaxel 175 mg/m2 and docetaxel 100 mg/m2 incur annual follow-up costs respectively of £3,746, £5,332, £5,977 and £6,766. The oral vinorelbine allows savings of £858 compared to its intravenous form, £2,444 compared to gemcitabine, £3,089 and £3,878 compared to paclitaxel and docetaxel per patient managed for one year. CONCLUSION: Oral vinorelbine has a less budgetary impact due to the reduction of the hospital expenditure.