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Economic burden of resected (stage IB-IIIA) non-small cell lung cancer in France, Germany and the United Kingdom
A retrospective observational study (LuCaBIS)
Andreas, S., Chouaid, C., Danson, S., Siakpere, O., Benjamin, L., Ehness, R., Dramard-Goasdoue, M.-H., Barth, J., Hoffmann, H., Potter, V., Barlesi, F., Chirila, C., Hollis, K., Sweeney, C., Price, M., Wolowacz, S., Kaye, J. A., & Kontoudis, I. (2018). Economic burden of resected (stage IB-IIIA) non-small cell lung cancer in France, Germany and the United Kingdom: A retrospective observational study (LuCaBIS). Lung Cancer, 124, 298-309. https://doi.org/10.1016/j.lungcan.2018.06.007
Objectives: New adjuvant treatments are being developed for patients with resected non-small cell lung cancer (NSCLC). Due to scarcity of real-world data available for treatment costs and resource utilization, health technology and cost-effectiveness assessments can be limited. We estimated the burden and cost-of-illness associated with completely resected stage IB-IIIA NSCLC in France, Germany and the United Kingdom (UK).
Materials and methods: Eligible patients were aged 18 years with completely resected stage IB-IIIA NSCLC between August 2009 and July 2012. Patients (living or deceased) were enrolled at clinical sites by a systematic sampling method. Data were obtained from medical records and patient surveys. Direct, indirect and patient out-of-pocket expenses were estimated by multiplying resource use by country-specific unit costs. National annual costs were estimated based on disease prevalence data available from published sources.
Results: 39 centers provided data from 831 patients of whom patient surveys were evaluable in 306 patients. Median follow-up was 26 months. The mean total direct costs per patient during follow-up were: (sic)19,057 (France), (sic)14,185 (Germany), and (sic)8377 (UK). The largest cost drivers were associated with therapies received ((sic)12,375 France; (sic)3694 UK), and hospitalization/emergency costs ((sic)7706 Germany). Monthly direct costs per patient were the highest during the distant metastasis/terminal illness phase in France ((sic)15,562) and Germany ((sic)6047) and during the adjuvant treatment period in the UK ((sic)2790). Estimated mean total indirect costs per patient were: (sic)696 (France), (sic)2476 (Germany), and (sic)1414 (UK). Estimates for the annual national direct cost were (sic)478.4 million (France), (sic)574.6 million (Germany) and (sic)325.8 million (UK).
Conclusion: To our knowledge, this is the first comprehensive study describing the burden of illness for patients with completely resected stage IB-IIIA NSCLC. The economic burden was substantial in all three countries. Treatment of NSCLC is associated with large annual national costs, mainly incurred during disease progression.
