Literature DB >> 26735844

The economic burden of brain metastasis among lung cancer patients in the United States.

A Guérin1, M Sasane2, K Dea1, J Zhang2, K Culver2, R Nitulescu1, E Q Wu3, A R Macalalad3.   

Abstract

OBJECTIVE: Brain metastases among lung cancer patients can impair cognitive and functional ability, complicate care, and reduce survival. This study focuses on the economic burden of brain metastasis in lung cancer-direct healthcare costs to payers and indirect costs to patients, payers, and employers-in the US.
METHODS: Retrospective study using claims data from over 60 self-insured Fortune 500 companies across all US census regions (January 1999-March 2013). Adult, non-elderly lung cancer patients with brain metastasis were evaluated over two study periods: (1) pre-diagnosis (≤30 days prior to first observed lung cancer diagnosis to ≤30 days prior to first-observed brain metastasis diagnosis) and (2) post-diagnosis (≤30 days prior to first observed brain metastasis diagnosis to end of continuous eligibility or observation). OUTCOME MEASURES: Healthcare costs to payers and resource utilization, salary loss to patients, disability payouts for payers, and productivity loss to employers.
RESULTS: A total of 132 patients were followed for a median of 8.4 and 6.6 months in the pre- and post-diagnosis periods, respectively. At diagnosis of brain metastasis, 21.2% of patients were on leave of absence and 6.1% on long-term disability leave. Substantial differences were observed in the pre- vs post-diagnosis periods. Specifically, patients incurred much greater healthcare utilization in the post-diagnosis period, resulting in $25,579 higher medical costs per-patient-per-6-months (PPP6M). During this period, patients missed significantly more work days, generating an incremental burden of $2853 PPP6M in salary loss for patients, $2557 PPP6M in disability payments for payers, and $4570 PPP6M in productivity loss for employers. LIMITATIONS: Type of primary lung cancer and extent of brain metastasis could not be assessed in the data. The analysis was also limited to patients with comprehensive disability coverage.
CONCLUSIONS: Development of brain metastasis among lung cancer patients is associated with a substantial economic burden to payers, patients, and employers.

Entities:  

Keywords:  Brain metastasis; Direct costs; Economic burden; Healthcare resource use; Indirect costs; Lung cancer; Productivity loss; Work loss

Mesh:

Year:  2016        PMID: 26735844     DOI: 10.3111/13696998.2016.1138962

Source DB:  PubMed          Journal:  J Med Econ        ISSN: 1369-6998            Impact factor:   2.448


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