OBJECTIVES: Gemcitabine/cisplatin (GC) is one of many novel chemotherapy regimens available for the treatment of non-small cell lung cancer. This study conducted two clinical trial-based economic evaluations comparing GC with other novel agent regimens in five European countries: France, Germany, Italy, Spain, and the UK. METHODS: The economic evaluations were conducted using evidence from two randomised, controlled trials of GC and the other novel regimens. The first analysis was based upon the trial published by Comella et al. (2000) and compared GC with vinorelbine/cisplatin (VC). The second analysis was based upon the trial published by Schiller et al. (2000) and compared GC with paclitaxel/cisplatin (PCI), paclitaxel/carboplatin (PCA) and docetaxel/cisplatin (DC). In these trials, pivotal health outcomes including overall and progression-free survival were similar between GC and the other regimens meaning cost-minimisation analysis was employed. RESULTS: The analysis based on Comella et al. (2000) found that GC was associated with lower total treatment costs than VC in all five countries. The overall cost savings associated with GC ranged from €802 in Spain to £1262 in the UK. The second analysis found that GC had lower total treatment costs than both of the paclitaxel regimens in all five countries. The overall cost savings for GC were greatest when compared against PCA and ranged from €2153 in Italy to €4846 in France. GC was associated with a small incremental cost compared to DC in Germany (€95 per patient) and was cost saving in the other four countries. CONCLUSIONS: GC was associated with lower total treatment costs than VC, PCI and PCA from the perspective of the national health services of five European countries. Given similar efficacy findings in these studies, a claim for cost-effectiveness of GC in the treatment of advanced NSCLC is supported.