Cost analysis of lung cancer management in South Western Sydney

Abstract

Introduction: Lung cancer is the leading cause of cancer mortality in Western nations, and associated health‐care costs are escalating. The aim of this study was to describe the current pattern of resource use and direct medical costs associated in managing lung cancer in South Western Sydney, Australia. Methods: All new cases of primary lung carcinoma discussed at the Liverpool and Macarthur Cancer Therapy Centre (CTC) Lung Cancer Multidisciplinary Team meeting or seen at CTC between 1 December 2005 and 21 December 2006 were reviewed. Staging investigations, hospitalisation, treatment and follow‐up investigations were documented from first consultation to last follow‐up (31 October 2008 or death). Cost estimates were based on the Australian Medicare Benefits Schedule and reported in Australian dollars. Infrastructure, staff and non‐medical costs were excluded. Results: There were 210 patients, median age 68.2 years (range 39–90) with median follow‐up of 16.6 months. The pathology and stage distribution were: 3.8% limited stage small cell lung cancer (SCLC), 10.0% extensive stage SCLC, 13.4% stage I and II non‐small cell lung cancer (NSCLC), 28.5% stage III NSCLC and 44.3% stage IV NSCLC. The estimated total cost for managing this patient cohort was A$2.91 million. The cost components were: staging investigations (10.1%), treatment 41.2% (2.8% surgery, 15.8% radiotherapy and 22.6% chemotherapy), hospitalisation (43.7%) and follow‐up investigations (5%). The median costs for managing NSCLC and SCLC subgroups were A$10 675 (range A$669–612 789) and A$14 799 (range A$908–31 057), respectively. Conclusion: Hospitalisation and cancer treatment, particularly chemotherapy, accounted for the major components of direct medical costs in the management of lung cancer.

Cost-components of lung cancer care within the first three years after initial diagnosis in context of different treatment regimens

“…Following, there was a substantial decline, which is line with previous research [8,17]. Hospitalization and outpatient chemotherapy were confirmed as the main cost drivers in lung cancer care (e.g., [6,18]). In our sample, spending on outpatient chemotherapy did not increase over time-contrary to a study in individuals all with metastatic lung cancer [19].…”

“…Clinically, these parameters are of utmost importance as they impact survival prognosis and the decision for a distinct treatment regimen [20]. Evidence on their cost impact, however, is contradictory [9,17,18]. We best possibly accounted for the effect of different disease stages by including baseline metastases and multiple tumors in our regressions.…”

Cost of screening for lung cancer in Australia

“…Real-world data on lung cancer treatment costs reveal direct medical costs are largely driven by hospitalisation and chemotherapy treatment, and that treating stage IV disease is more expensive than surgical treatment of stage I-II disease. 27,28 Our data support this, the average direct medical cost of surgery was AU$22 659 compared to the average non-surgical cost of AU$47 395 (radiotherapy, chemotherapy, palliative care). These findings are similar to the Canadian PanCan screening study which estimated the mean per-person cost of treating lung cancer with curative surgery was CAD33 344 over 2 years compared to CAD47 792 to treat advanced-stage lung cancer with chemotherapy, radiotherapy or supportive care alone.…”

“…The timing of QLCSS has to be placed in context: management of lung cancer has progressed rapidly in the past decade; increasing prevalence of peripheral adenocarcinomas, more aggressive treatments in physiologically less robust patients, lung preserving surgery, stereotactic radiation therapy, targeted biologic agents and immunotherapy create a moving target to assess lung cancer treatment costs. Real‐world data on lung cancer treatment costs reveal direct medical costs are largely driven by hospitalisation and chemotherapy treatment, and that treating stage IV disease is more expensive than surgical treatment of stage I‐II disease . Our data support this, the average direct medical cost of surgery was AU$22 659 compared to the average non‐surgical cost of AU$47 395 (radiotherapy, chemotherapy, palliative care).…”

Si-RNA mediated knockdown of CELF1 gene suppressed the proliferation of human lung cancer cells

“…With increasing mortality rates, lung carcinoma has already become the leading cause of cancer mortality in the world [11]. Many genes are subjected to post-transcriptional regulation via control of the rate of mRNA turnover for transcripts bearing destabilizing cis -elements [12].…”