Economic burden of advanced non-small cell lung cancer (NSCLC): a systematic literature review.
Nick Jovanoski, Gavneet Kaur, Hemlata Shukla et al.
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In 30 seconds
This systematic literature review examined healthcare use and costs among patients with locally advanced or metastatic NSCLC, drawing on 50 publications covering 43 studies published from 2011 onwards. Resource use was substantial: reported hospitalization rates ranged from 13.0% to 98.2% of patients, and outpatient visits from 74.6% to 100.0%. Mean direct costs ranged from US$5,647 (Brazil) to US$158,908 (US) over 12-24 months. Costs and resource use were generally higher with metastatic disease and brain/CNS metastases, although estimates varied considerably across countries and studies.
Key findings
- Hospitalization was reported for 13.0% to 98.2% of patients; outpatient visits ranged from 74.6% to 100.0%.
- Mean direct costs ranged from US$5,647 (Brazil) to US$158,908 (US) over 12-24 months.
- Brain/CNS metastases were a major factor associated with higher healthcare resource use and costs.
- Costs were higher for chemotherapy than immunotherapy, while resource use appeared lower with immunotherapy than chemotherapy.
Why it matters
The review indicates that advanced NSCLC is associated with substantial healthcare use and financial burden, with costs differing markedly by country and clinical factors. Recognising the contribution of metastatic disease, brain/CNS involvement, treatment type and comorbidities can help clinicians and health systems interpret resource needs and cost estimates in context.
What to keep in mind
The review was qualitative, with no formal quantitative synthesis. Different currencies and study heterogeneity limited cost comparisons, and data extraction was performed by a single reviewer.