In two recent randomised trials, gemcitabine plus cisplatin (Gem/Cis) was found to be at least as effective as vinorelbine plus cisplatin (Vin/Cis), paclitaxel plus cisplatin (Pac/Cis), paclitaxel plus carboplatin (Pac/Carbo), or docetaxel plus cisplatin (Doc/Cis) in patients with advanced non-small cell lung cancer (NSCLC). In cost-minimisation analyses of these studies from the perspectives of the national health services of five European countries (France, Germany, Italy, Spain, UK), Gem/Cis was associated with lower average treatment-related costs than Vin/Cis, Pac/Cis, and Pac/Carbo, and similar or lower costs than Doc/Cis. The incremental cost savings per patient of Gem/Cis compared to Vin/Cis ranged from 827 Euro to 2055 Euro per patient and from 1616 Euro to 5342 Euro compared to the paclitaxel-containing regimens. Overall, results were generally similar between countries, and were robust to univariate sensitivity analyses. Although differences in healthcare systems mean that the results may not be generalisable to all countries/settings, these results provide an economic rationale for the use of Gem/Cis as a first-line treatment option in Europe for patients with NSCLC.