Treatment cost of non-small cell lung cancer in three European countries: comparisons across France, Germany, and England using administrative databases.

INTRODUCTION: Lung cancer is a highly prevalent condition with non-small cell lung cancer (NSCLC), representing ∼ 80%. Given its high prevalence and poor survival rates, it is important to understand costs associated with NSCLC treatment.
OBJECTIVES: To carry out an incidence-based study in three European countries: France, Germany, and the UK, to estimate the cost of NSCLC treatment.
METHODS: Three similar administrative databases were accessed; Hospital Episode Statistics (England), Gesundheitsforen Leipzig (Germany), French Hospital Discharge system (France), using ICD-9/10 codes and treatment/surgery algorithms to identify NSCLC patients. An incidence population of NSCLC patients was obtained using an index year (ranging from 2007-2008), ensuring the absence of prior lung cancer (12-months). Data were extracted on treatment information, patient characteristics, and disease staging. Average NSCLC treatment costs were estimated by age and severity. For England, 20,081 patients were identified, for France, 15,061, and for Germany, 1038.
RESULTS: In-patient length of stay was 8.9, 8.7, and 10.1 days for France, England, and Germany, respectively, for the first year. Average total costs for the 2-year follow-up period for France, England, and Germany were €25,063, €17,777, and €32,500, respectively. Sub-group analyses showed higher costs for younger patients and those with metastatic disease.
CONCLUSION: Considerable differences in average treatment costs were observed. In-patient costs dominate in the first year of treatment in all countries. The study highlights the costly nature of NSCLC.