Healthcare Costs and Resource Utilisation of Italian Metastatic Non-Small Cell Lung Cancer Patients

Nicola Gentili ¹, William Balzi ¹, Flavia Foca ²

⁰Outcome Research, Healthcare Administration, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy.

Cancers +

|

February 10, 2024

View abstract on PubMed

Summary

The introduction of first-line immuno-oncology (IO) therapy for non-small cell lung cancer increased treatment costs but improved survival. Patients with specific mutations incurred higher overall healthcare expenses compared to those without.

Area Of Science

Oncology
Health Economics

Background

Metastatic non-small cell lung cancer (NSCLC) presents a significant economic burden.
The advent of immuno-oncology (IO) regimens has altered treatment paradigms and associated costs.

Purpose Of The Study

To evaluate the economic impact of first-line (1L) IO therapy in metastatic NSCLC patients.
To compare healthcare costs and healthcare resource utilization (HCRU) before and after the availability of 1L IO treatments.

Main Methods

Retrospective analysis of 644 metastatic NSCLC patients from 2014-2020.
Patients categorized by mutational status (mutation-positive vs. negative/unknown) and treatment era (pre- vs. post-1L IO availability).
Comparison of mean total and per-month healthcare costs and HCRU for 1L treatment and overall follow-up.

Main Results

Mutation-positive patients incurred substantially higher 1L and overall follow-up costs compared to negative/unknown groups.
Introduction of 1L IO (pembrolizumab) increased mean 1L costs (EUR 7,804 pre-IO vs. EUR 19,301 post-IO) but was associated with improved survival.
Therapy costs dominated 1L expenses, while hospitalization costs increased during follow-up, particularly in the negative/unknown group.

Conclusions

While 1L IO therapy for NSCLC increases upfront costs, it is associated with improved survival outcomes.
Economic burden varies significantly based on mutational status, with mutation-positive patients facing higher long-term costs.
Increased hospitalization and emergency room utilization in the negative/unknown group post-IO suggests poorer clinical trajectories compared to mutation-positive counterparts.

Keywords:

Italy administrative databases costs economics healthcare resource utilisation (HCRU) immunotherapy non-small cell lung cancer (NSCLC) real-world evidence