End-of-Life Health-Care Cost of Patients With Lung Cancer: A Retrospective Study

Abstract

Introduction: Lung cancer exerts a significant societal and health-care–related economic burden and chemotherapy drugs constitute a major factor of total direct cost. The aim of the present study was to assess the direct health-care cost of lung cancer in Greece by conducting a retrospective analysis on the last 6 months of life. Methods: The present study was based on both the medical data and costs of treatment of deceased adult patients who suffered from terminal stage IIIB/IV lung cancer (non-small cell lung cancer and small cell lung cancer) during the last 6 months of their life. The study’s protocol was approved by the Hospital’s Research Ethics Committee. Costs included outpatient (outpatient services) and inpatient (inpatient services) costs. Descriptive statistics were mainly used for statistical analysis. Results: The files of 144 patients were analyzed. The total cost of health-care services for the study population during the last 6 months of life was attributed by 57% to inpatient services, whereas chemotherapy costs (74%) comprised the largest proportion of the total inpatient cost. The highest expenditure for outpatient services was attributed to concomitant medication (59%), followed by the cost of tests (21%) and radiotherapy (20%). Conclusions: The results of our study indicate that both inpatient and outpatient costs were substantial. The main inpatient and outpatient cost drivers were chemotherapy and concomitant medication, respectively. A more comprehensive nationwide study would be useful to validate our results and to include also indirect costs of cancer care in Greece.

Cost-effectiveness of real-world administration of chemotherapy and add-on Viscum album L. therapy compared to chemotherapy in the treatment of stage IV NSCLC patients

“…This is in line with the results of other studies published indicating that end of life is one of the most expensive periods of cancer treatment [28]. Calculations of an actual in-depth cost study on 230 patients with the majority of NSCLC (78%) in an advanced stage revealed that the key drivers of the last six month of life were CTx (39%), concomitant medication (14%) and cost of hospitalization (14%) [29]. Our cost-effectiveness analysis reveal, that the combinatorial therapy was not inferior against the treatment standard, as it resulted in relevant hospital savings for CTx plus add-on VA per gained survival year compared to CTx alone.…”

“…This is in line with the results of other studies published indicating that end of life is one of the most expensive periods of cancer treatment [ 28 ]. Calculations of an actual in-depth cost study on 230 patients with the majority of NSCLC (78%) in an advanced stage revealed that the key drivers of the last six month of life were CTx (39%), concomitant medication (14%) and cost of hospitalization (14%) [ 29 ].…”

Cost-effectiveness of real-world administration of chemotherapy and add-on Viscum album L. therapy compared to chemotherapy alone in the treatment of stage IV NSCLC patients

“…This is in line with the results of other studies published indicating that end of life is one of the most expensive periods of cancer treatment [27]. Calculations of an actual in-depth cost study on 230 patients with the majority of NSCLC (78%) in an advanced stage revealed that the key drivers of the last six month of life were chemotherapy (39%), concomitant medication (14%) and cost of hospitalization (14%) [28]. To our knowledge, this is the first study to directly analyse the cost and cost effectiveness of chemotherapy plus VA therapy compared to chemotherapy alone in stage IV NSCLC patients based on real world patient data and hospital costs in Germany.…”

State-Level Disparity in Lung Cancer Survival in the United States

“…Therefore, our findings may be a reflection of the profound impact that health policies and delivery at a state level have on clinical outcomes. Early detection and appropriate treatments for lung cancer, including surgical interventions and advanced therapies, lead to large health expenditures (30)(31)(32). For example, Vera-Llonch et al in their study, indicated that health care costs among patients with metastatic lung cancer receiving chemotherapy are substantial, exceeding $125,000 per patient over a mean follow-up period of 500 days.…”