Stefan Andreas1, Christos Chouaid2, Sarah Danson3, Obukohwo Siakpere4, Laure Benjamin5, Rainer Ehness6, Marie-Hélène Dramard-Goasdoue7, Janina Barth8, Hans Hoffmann9, Vanessa Potter10, Fabrice Barlesi11, Costel Chirila12, Kelly Hollis13, Carolyn Sweeney14, Mark Price15, Sorrel Wolowacz16, James A Kaye17, Ilias Kontoudis18. 1. Lungenfachklinik Immenhausen, Krs. Kassel and Universitätsmedizin Göttingen, 37075, Göttingen, Germany. Electronic address: stefan.andreas@med.uni-goettingen.de. 2. CHI Créteil, Créteil, France. Electronic address: Christos.chouaid@chicreteil.fr. 3. Academic Unit of Clinical Oncology, Weston Park Hospital, Sheffield, United Kingdom. Electronic address: s.danson@sheffield.ac.uk. 4. GSK, Middlesex, United Kingdom. Electronic address: obukohwo.2.siakpere@gsk.com. 5. GSK, Rueil-Malmaison, France. Electronic address: laurebenjamin29@gmail.com. 6. GSK, 81675, Munich, Germany. Electronic address: rainer.ehness@novartis.com. 7. GSK, Rueil-Malmaison, France. Electronic address: mhdg@wanadoo.fr. 8. GSK, 81675, Munich, Germany. Electronic address: janina.barth@novartis.com. 9. Thoraxklinik, University of Heidelberg, Heidelberg, Germany. Electronic address: hans.hoffmann@med.uni-heidelberg.de. 10. Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom. Electronic address: Vanessa.potter@uhcw.nhs.uk. 11. Assistance Publique Hôpitaux de Marseille, Multidisciplinary Oncology and Therapeutic Innovations Department, Aix Marseille University, Centre d'Investigation Clinique, Marseille, France. Electronic address: fabrice.barlesi@ap-hm.fr. 12. RTI Health Solutions, Research Triangle Park, NC, United States. Electronic address: cchirila@rti.org. 13. RTI Health Solutions, Research Triangle Park, NC, United States. Electronic address: khollis@rti.org. 14. RTI Health Solutions, Research Triangle Park, NC, United States. Electronic address: csweeney@rti.org. 15. RTI Health Solutions, Research Triangle Park, NC, United States. Electronic address: mprice@rti.org. 16. RTI Health Economics, RTI Health Solutions, The Pavilion, Towers Business Park, Wilmslow Road, Manchester, United Kingdom. Electronic address: swolowacz@rti.org. 17. Epidemiology, RTI Health Solutions, Waltham, MA, United States. Electronic address: jkaye@rti.org. 18. GSK, Rixensart, Belgium. Electronic address: iliaskontoudis@gmail.com.
Abstract
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 €8377 (UK). The largest cost drivers were associated with therapies received (€12,375 France; €3694 UK), and hospitalization/emergency costs (€7706 Germany). Monthly direct costs per patient were the highest during the distant metastasis/terminal illness phase in France (€15,562) and Germany (€6047) and during the adjuvant treatment period in the UK (€2790). Estimated mean total indirect costs per patient were: €696 (France), €2476 (Germany), and €1414 (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.
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 €8377 (UK). The largest cost drivers were associated with therapies received (€12,375 France; €3694 UK), and hospitalization/emergency costs (€7706 Germany). Monthly direct costs per patient were the highest during the distant metastasis/terminal illness phase in France (€15,562) and Germany (€6047) and during the adjuvant treatment period in the UK (€2790). Estimated mean total indirect costs per patient were: €696 (France), €2476 (Germany), and €1414 (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.