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e17505 Background: Generic substitution may lead to increased access to cancer drugs. Little data have been published on cost savings in emerging markets. Methods: Estimate of cost and savings per cycle, per patient, and for India with generic drugs. Cost of paclitaxel, docetaxel, gemcitabine, irinotecan and oxaliplatin was obtained for originator branded and generic versions from a distributor in India. Costs are depicted in 2012 Rupees. Utilization was based on a BSA of 1.7, standard doses, expected lenght of treatment for common oncology indications and incidence data from GLOBOCAN. Results: Generic drugs cost from 8.9% to 36% of their equivalent branded originator drug, resulting in cost-savings of approximately INR 11,000 to 90,000 [US$ 200-1,600] per each drug per cycle; and approximately INR 50,000 to 240,000 [US$ 900-4,300] per patient treated. Overall, potential yearly savings for health systems in India were nearly INR 47 billion [US$ 843 million]. Conclusions: Generic substitution for commonly used chemotherapy agents has an enormous potential to generate significant cost-savings and increase access to cancer treatments in India and other low and middle income countries. [Table: see text]