Yu Xia1,2, Yi Yang1,2, Chunxia Su3, Jia Chen4, Enwu Long5, Haibo Zhang6, Yuying Gan7, Fei Yan8, Yingyao Chen9,10. 1. School of Public Health, Fudan University, Shanghai, China. 2. National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China. 3. Department of Oncology, Shanghai Pulmonary Hospital & Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China. 4. Department of Medical Oncology, The Affiliated Tumor Hospital of Nantong University & Nantong Tumor Hospital, Nantong, China. 5. Department of Pharmacy, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Sichuan, China. 6. Department of Organization and Personnel, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China. 7. Department of Respiratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China. 8. Department of Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China. 9. School of Public Health, Fudan University, Shanghai, China. yychen@shmu.edu.cn. 10. National Health Commission Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China. yychen@shmu.edu.cn.
Abstract
PURPOSE: This study was conducted to estimate the indirect cost of locally advanced and metastatic non-small cell lung cancer (NSCLC) without sensitizing EGFR and ALK alterations in China and explore the predictors from both patient and caregiver perspectives. METHODS: Data were obtained from a nationwide cross-sectional study for the patients with advanced NSCLC (stage IIIB-IV) and their caregivers. Indirect medical cost was estimated as health productivity loss based on self-reported income and loss of work time. The generalized linear model was used to assess the independent associations between statistically significant variables and indirect economic burden. RESULTS: 611 pairs of patients and patient caregivers from 13 medical centers in five provinces in China participated in this investigation. The indirect medical cost associated with advanced NSCLC since the patient diagnosed was $1413 per capita in China. General linear regression results showed that the indirect medical cost was significantly influenced by duration of disease since diagnosis, treatment options, caregivers' occupation and age (P < 0.05). CONCLUSION: The indirect economic burden linked to advanced NSCLC in China is considerable on patients, and their caregivers. To minimize the severe challenges of indirect economic burden related to advanced NSCLC, expanding the coverage of the medical insurance and assistance system to reimburse part of the indirect costs related to cancer, as well as strengthening the accessibility for more effective therapies to improve the prognosis of advanced NSCLC, and further promote the patients and their caregivers to return to work or normal life may be the potentially feasible approaches.
PURPOSE: This study was conducted to estimate the indirect cost of locally advanced and metastatic non-small cell lung cancer (NSCLC) without sensitizing EGFR and ALK alterations in China and explore the predictors from both patient and caregiver perspectives. METHODS: Data were obtained from a nationwide cross-sectional study for the patients with advanced NSCLC (stage IIIB-IV) and their caregivers. Indirect medical cost was estimated as health productivity loss based on self-reported income and loss of work time. The generalized linear model was used to assess the independent associations between statistically significant variables and indirect economic burden. RESULTS: 611 pairs of patients and patient caregivers from 13 medical centers in five provinces in China participated in this investigation. The indirect medical cost associated with advanced NSCLC since the patient diagnosed was $1413 per capita in China. General linear regression results showed that the indirect medical cost was significantly influenced by duration of disease since diagnosis, treatment options, caregivers' occupation and age (P < 0.05). CONCLUSION: The indirect economic burden linked to advanced NSCLC in China is considerable on patients, and their caregivers. To minimize the severe challenges of indirect economic burden related to advanced NSCLC, expanding the coverage of the medical insurance and assistance system to reimburse part of the indirect costs related to cancer, as well as strengthening the accessibility for more effective therapies to improve the prognosis of advanced NSCLC, and further promote the patients and their caregivers to return to work or normal life may be the potentially feasible approaches.
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