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.