Nowadays we are in the middle of the biggest economic crisis of the new millennium and healthcare system could have many problems to assure pharmaceutical care for everyone. The cost of oncology’s drugs has been increasing for ten years with the marketing of the new therapies with monoclonal antibodies. In the Azienda Ospedaliera Universitaria Senese (AOUS) we analyzed the protocol of therapies for Non Small Cell Lung Cancer (NSCLC) looking for the standard costs of first and second line therapies. To create Standard Costs it has been calculated costs of drugs, cost of personnel who was involved in administration and preparation of these drugs such as nurses, physicians, pharmacists, and cost of diagnostic tests related to pharmaceutical care of NSCLC. It has been done a comparison between total costs and the DRG related to the performance. The first line therapy which provided a low rate of monoclonal antibodies and other expensive drugs had a medium standard cost of € 338 for each admission, instead the second line therapy which had a medium standard cost of € 932 due to the high percentage of use of bevacizumab and pemetrexed. We underlined the need of reforming the DRG model to help our healthcare system to be economically sustainable. It should be thought to assign department budget elaborated on the real costs of care activities.

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Key words: standard costs,  oncology, high cost  therapies, economic assessment, economic sustainability