OBJECTIVES: Existing reports of utility values for second-line advanced non-small cell lung cancer (NSCLC) vary quite widely and are not optimal for use in health technology assessments within the UK. The aim of this study was to elicit UK societal-based utility values for different tumour response statuses and different grade 3 and 4 toxicities commonly associated with NSCLC chemotherapy treatments. METHODS: Toxicities considered were neutropenia, febrile neutropenia, fatigue, diarrhoea, nausea and vomiting, rash and hair loss. Each health state described the symptom burden of disease and impact on different levels of functioning (physical, emotional, sexual, and social). The disutility related to each response status and toxicity was estimated and combined to give health state values. Existing health state descriptions of metastatic breast cancer were revised to make them suitable as descriptions of NSCLC patients receiving second-line chemotherapy. The existing health states were used in cognitive debrief interviews with oncologists (n=5) and oncology specialist nurses (n=5). Changes were made as suggested by these clinical experts. The resulting health states (n=17) were piloted and used in a societal-based valuation study (n=100). Participants rated half of the total health states in a standard gamble interview to derive health state utility scores. Data were analysed using a mixed model analysis. This study was conducted in line with standard NICE appraisal methodology. RESULTS: All tumour response statuses and toxicities were independent significant predictors of utility (p<0.001). Stable disease with no toxicity (our base state) had a utility value of 0.65. Utility scores ranged from 0.67 (responding disease with no toxicity) to 0.47 for progressive disease. CONCLUSION: This study reflects the value that society places on the avoidance of disease progression and severe toxicities associated with the treatment of second-line advanced NSCLC.