OBJECTIVES: Gemcitabine/Cisplatin (Gem/Cis) is a standard regime commonly used in the treatment of non-small cell lung cancer. This study uses currently available clinical trial data to evaluate the cost implications of Gem/Cis versus other combination regimes in Germany. METHODS: Two published randomised controlled clinical trials were used for this retrospective cost analysis to evaluate and compare the cost of platinum-based combination regimes. Comella et al. (2000) compared, among others, Gem/Cis versus Vinorelbine/Cisplatin (Vin/Cis) and Schiller et al. (2000) compares Gem/Cis with Paclitaxel/Cisplatin (Pac/Cis), Paclitaxel/Carboplatin (Pac/Carbo) and Docetaxel/Cisplatin (Doc/Cis). Equal efficacy was assumed for the analysis. Resource use and unit costs associated with both treatment and toxicity management were collected from the perspective of a German sickness fund. Only direct cost (acquisition and administration of chemotherapy, hospitalisation and other medical resource use) were considered. RESULTS: Based on the Comella et al. (2000) clinical trial, Gem/Cis was associated with lower overall costs compared to Vin/Cis (€7638 vs. €8143). The higher acquisition cost of Gem/Cis was more than compensated by lower drug administration cost (€798 vs. €1278) and fewer adverse events resulting in fewer hospitalisations (€1633 vs. €2680). Based on the Schiller et al. (2000), Gem/Cis was associated with the lowest overall costs of all first-line treatment arms, Pac/Carbo and Pac/Cis (€8.418 vs €12.268 and €11.050). Even though the drug acquisition cost of Gem/Cis was lower than Doc/Cis, higher administration cost lead to slightly higher total cost of Gem/Cis compared to Doc/Cis (€8418 vs. €8331). CONCLUSIONS: From the perspective of German sickness funds, Gem/Cis as first line treatment offers cost advantages over Pac/Cis and Pac/Carbo in the treatment of non-small cell lung cancer. Further research is necessary to validate these findings in a setting outside of clinical trials.