Economic burden of resected (Stage IB-IIIA) non-small cell lung cancer in France, Germany and the United Kingdom: a retrospective observational study (LuCaBIS)
Menée dans un contexte français, allemand et britannique à partir de données portant sur 306 patients atteints d'un cancer du poumon non à petites cellules de stade IB-IIIA ayant subi une résection complète entre 2009 et 2012, cette étude rétrospective analyse, dans ces trois pays, les coûts directs et indirects associés aux traitements et aux soins reçus, ainsi que les coûts restant à la charge des patients
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: €19,057 (France), €14,185 (Germany), and €8,377 (UK). The largest cost drivers were associated with therapies received (€12,375 France; €3,694 UK), and hospitalization/emergency costs (€7,706 Germany). Monthly direct costs per patient were the highest during the distant metastasis/terminal illness phase in France (€15,562) and Germany (€6,047) and during the adjuvant treatment period in the UK (€2,790). Estimated mean total indirect costs per patient were: €696 (France), €2,476 (Germany), and €1,414 (UK). Estimates for the annual national direct cost were €478.4 million (France), €574.6 million (Germany) and €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