OBJECTIVES: To compare the efficiency (the evaluation of efficacy in relation to costs) of three first-line treatment options for advanced non-small-cell lung cancer (stage IIIB and IV) used in the ECOG study: docetaxel/cisplatin (75/75 mg/m2/day; 1 hour IV infusion of docetaxel); paclitaxel/cisplatin (175/75 mg/m2/day; 3 or 24 hour IV infusion of paclitaxel), and paclitaxel/carboplatin (175/400 or 225/400 mg/m2/day; 3 hour IV infusion of paclitaxel). METHODS: The results of the ECOG 1594 phase III clinical trial demonstrated equivalent efficacy (survival, objective response) between the treatment options. To differentiate between the treatment options, we performed a cost-minimization analysis, using a pharmacoeconomic model. RESULTS: The average estimated treatment cost per patient (median, four cycles) with docetaxel/cisplatin would be 1,067,836 Spanish pesetas (Ptas) (6,418 Euros, €; 5,741 US Dollars, USD), 1,365,304 or 1,439,369 Ptas (8,205 or 8,651 €; 7,340 or 7,738 USD) with paclitaxel/cisplatin (3 or 24 hour infusions, respectively), and 1,417,995 or 1,616,784 Ptas (8,522 or 9,717 €; 7,623 or 8,692 USD) (paclitaxel dose of 175 or 225 mg/m2/day, respectively) with paclitaxel/carboplatin. CONCLUSIONS: According to our study, the treatment option docetaxel/cisplatin, with equal efficacy, would result in a cost saving of between 297,468 and 548,948 Ptas (1,788 and 3,299 € or 1,599 and 2,951 USD) per patient treated. This difference is mainly due to the lower treatment cost associated with docetaxel.