Abstract: Objective: To evaluate the cost-utility of EGFR- TKIs in the treatment of advanced non-small cell lung cancer using Markov mode. Methods: Built Markov state transition model to simulate the dynamic changes of the four states(stable disease,response,progressive disease and death) in the patients who received the gefitinib or erlotinib or icotinib treatment.Applied Markov model using Roll back analysis and Markov cohort simulation to project the costs and utility for the patients who had been long-term treated with EGFR- TKIs. One way sensitivity analysis was carried out to determine the robustness of this baseline results. Results: The results of cost-utility analysis showed that patients receiving icotinib cumulative costs and utilities were 375594.37 yuan and 1.50 quality-adjusted life years gained; Patients receiving gefitinib cumulative costs and utilities were 531222.33 yuan and 1.51 quality-adjusted life years gained; Patients receiving erlotinib cumulative costs and utilities were 694611.22 yuan and 1.51 quality-adjusted life years gained. According to the sensitivity analysis, the change of key parameters in the set range did not affect the model results.Conclusion: In conclusion, icotinib treatment was more economical than gefitinib and erlotinib treatment for NSCLC patients.