The Economic Burden Associated With Treating Resected Non-Small Cell Lung Cancer in the US

OBJECTIVES: There have been recent advances in the treatment of resected non-small cell lung cancer (rNSCLC). The objective of this study is to describe the historic economic burden of managing rNSCLC.

METHODS: This observational cohort study utilized Medicare Advantage and commercial claims data from the Optum Clinformatics Data Mart. Included were adults with evidence of NSCLC diagnosis between July 2017 and Feb 2023, surgical resection (≤4 months post-diagnosis), no evidence of metastasis within 90 days post-diagnosis, and >1 month in the insurance plan post-diagnosis. Exclusion criteria were evidence of cancer in the baseline period, clinical trial participation, or osimertinib prescription. Index date was the date of diagnosis. Patients were divided into five treatment phases: pre-surgery phase (30 days pre-index to surgery), 30 day surgery phase, initial post-surgery phase (180 days following surgery phase), long-term follow up phase (>180 days post-surgery phase), and a 60 day end-of-life phase (for deceased). Descriptive statistics evaluated per patient per month (PPPM) treatment costs.

RESULTS: A total of 10,563 patients were included with a median age of 71 and median of 1.4 comorbidities. Most patients were Medicare insured (9,062; 85.8%) and female (6,222; 58.9%). The mean PPPM cost for the pre-surgery phase was $7,470 (Standard Deviation=8,020; N=10,563). The mean PPPM cost for the surgery phase was $59,594 (SD=57,423; N=10,414). The mean PPPM cost for the initial post-surgery phase was $3,752 (SD=12,637; n=10,241). The mean PPPM cost for long-term follow up phase was $2,786 (SD=9,088; N=8,391). The mean PPPM cost for the end-of-life phase was $37,128 (SD=118,238; N=1,494).

CONCLUSIONS: These results highlight the historic cost of treating rNSCLC and can inform economic models to assess the value of new therapies which may reduce recurrence and mortality.