Healthcare costs in patients with metastatic lung cancer receiving chemotherapy

Abstract

BackgroundTo characterize healthcare resource utilization and costs in patients with metastatic lung cancer receiving chemotherapy in the US.MethodsUsing data from a large private multi-payer health insurance claims database (2000-2006), we identified all patients beginning chemotherapy for metastatic lung cancer. Healthcare resource use (inpatient, outpatient, medications) and costs were tallied over time from date of therapy initiation ("index date") to date of disenrollment from the health plan (in most instances, presumably due to death) or the end of the study period, whichever occurred first. Healthcare utilization and costs were characterized using Kaplan-Meier sample average methods.ResultsThe study population consisted of 4068 patients; mean (SD) age was 65 (11) years. Over a median follow-up of 334 days, study subjects averaged 1.5 hospital admissions, 8.9 total inpatient days, and 69 physician office and hospital outpatient visits. Mean (95% CI) cumulative total healthcare costs were $125,849 ($120,228, $131,231). Costs of outpatient medical services and inpatient care constituted 34% and 20% of total healthcare costs, respectively; corresponding estimates for outpatient chemotherapy and other medication were 22% and 24%.ConclusionOur study sheds additional light on the burden of metastatic lung cancer among patients receiving chemotherapy, in terms of total cost thru end of life as well as component costs by setting and type of service, and may be useful in informing medical resource allocation in this patient population.

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

“…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]. Thus, the application of cost-intense innovative targeted therapies as some kind of ultima ratio might only apply for some subpopulation of lung cancer patients.…”

Use of Bevacizumab in Community Settings: Toxicity Profile and Risk of Hospitalization in Patients With Advanced Non–Small-Cell Lung Cancer

“…39 Another retrospective study of utilization and costs associated with adult patients with metastatic lung cancer (not specific to NSCLC) found that 72% of patients had a hospitalization after the initiation of chemotherapy. 15 Although the characteristics and inclusion/exclusion criteria used in our study are differ- ent from these studies, our findings do confirm that a large proportion of patients with advanced lung cancer are hospitalized after initiating a variety of chemotherapy regimens. Our study adds to the literature by providing the distribution of outcomes by chemotherapy regimen.…”

“…15 These studies did not assess hospitalization specifically after bevacizumab treatment. Describing the patterns of toxicity profiles and hospitalizations associated with bevacizumab use in a community setting is important because it directly addresses the need for more clinically relevant information regarding the potential balance of benefits and harms for an expensive drug that may confer only limited improvements in survival.…”

Treatment Patterns and Healthcare Costs among Patients with Advanced Non-Small-Cell Lung Cancer

“…In addition, provider payments under Medicare are significantly less than commercial insurance reimbursement rates [110]. In a study of metastatic lung cancer patients that did not distinguish costs between lines of therapy, the mean total healthcare costs averaged US$125,849 over 500 days in 2000-2006 [15]. The mean second-line therapy costs over 12 months were US$35,032-75,310 for lung cancer patients receiving treatment in 2002-2006 [3].…”