Real-World Outpatient Cost of Care Among Patients with Non-Small Cell Lung Cancer (NSCLC) Treated in the US Community

OBJECTIVES: Standards of care for non-small cell lung cancer (NSCLC) have significantly evolved over the past few years. We evaluated outpatient cost of care and changes in cost over time among patients with NSCLC treated in a large network of US community oncology clinics.

METHODS: Adult patients with NSCLC cancer in the US Oncology Network from March 2015 through June 2022 were included. Data were sourced from iKnowMed™ (iKM), an oncology-specific electronic health record system that captures outpatient practice encounter histories as well as demographics and clinical information for nearly 40% of US community oncology practices. iKM records are deterministically linked to claims and remittance data, which have paid amount. All costs were standardized to 2022 US dollars ($) and analyzed descriptively as cost per patient per month (PPPM) longitudinally since 2015.

RESULTS: The study included an eligible subset of 29,689 patients across all 4 census divisions in the US. The median [Q1, Q3] age was 68 [61, 75], 49% were women, 71% were white, 7% were treated in rural areas. The payer type distribution for this study cohort was 46% commercial, 48% Medicare, 6% Medicaid, and 0.4% other. The median [Q1, Q3; same below] total outpatient medical care cost was $4.1k [1.2k, 8.7k] PPPM. Majority of the outpatient cost was for chemotherapies $2.4k [0.3k, 7.1k]. There was a significant increase in costs over the past 5 years, from $1.9k [0.5k, 4.6k] in 2015 to $5.8k [2.3k, 10.7k] in 2022 (p<0.001).

CONCLUSIONS: This retrospective study of patients with NSCLC assessed the cost of care in community oncology settings in the US and shows that the cost of treating NSCLC has increased over time. Results may provide oncology stakeholders with insights into how advancements in NSCLC care influences rising costs.