OBJECTIVES: Lung cancer is a leading cause of morbidity and mortality. Chemotherapy is a main treatment option but its availability in the UK is limited in comparison to other countries and is not consistent across geographical regions. The present study reports on two economic evaluations of Gemzar/cisplatin relative to: paclitaxel/cisplatin, paclitaxel/carboplatin, docetaxel/cisplatin (evaluation 1); and vinorelbine/cisplatin (evaluation 2). METHODS: The perspective is that of the UK-NHS. Information was derived from randomised clinical trials (Schiller et al 2000 (evaluation 1), Comella et al 2000 (evaluation 2)). Total treatment costs include: chemotherapy and infusion, hospitalisations, visits to health care professionals, and concomitant medications. Resource utilisation information was combined with unit cost data from various UK sources. Costs relate to 2000 and were adjusted with the NHS inflation index if necessary. The time horizon for the estimation of costs is one year; hence discounting was unnecessary. Treatment effectiveness is mainly measured by time to disease progression and overall survival. RESULTS: In the first evaluation the cost per patient in the Gemzar/cisplatin, paclitaxel/cisplatin, paclitaxel/carboplatin, docetaxel/cisplatin arms was £5,537, £9,043, £8,444, and £5,779 respectively. Thus, the Gemzar/cisplatin achieves cost savings up to -£3506, which is driven by lower chemotherapy costs. Progression-free-life-years for each treatment arm, in the order presented above, were 0.375, 0.292, 0.300 and 0.275 respectively. Thus, the Gemzar/cisplatin combination dominates the other three combinations. In evaluation 2, a conservative approach was used whereby the survival outcome was assumed to be equivalent between Gemzar/cisplatin and vinorelbine/cisplatin arms. However, the cost in the Gemzar/cisplatin arm was £4,476 and in the vinorelbine/cisplatin arm £5,047. Despite significant changes to important parameters Gemzar with cisplatin maintains dominance or achieves very low positive incremental cost-effectiveness ratios, the maximum of which is £1,200. CONCLUSIONS: Gemzar/cisplatin is less expensive and equally or more effective than the other alternative regiments. Thus, on cost-effectiveness grounds, it should be encouraged in the treatment of NSCLC patients in the UK.