Economic Burden of Lung Cancer from the Perspective of a Brazilian Public Hospital
Author(s)
Rodrigo Saar Costa, PhD1, Debora Gonçalves, MSc2, Cristiano Guedes Duque, MSc3, Valeria Coutinho, Spec.3, Caio Martins, BSc4, Leticia Jabase, PgD4, Bengt Liljas, PhD5.
1Pharmacist, Doctor, INCA, Rio de Janeiro, Brazil, 2Pharmacist, Master, INCA, Rio de Janeiro, Brazil, 3Physician, INCA, Rio de Janeiro, Brazil, 4AstraZeneca, Cotia, Brazil, 5AstraZeneca, Gaithersburg, MD, USA.
1Pharmacist, Doctor, INCA, Rio de Janeiro, Brazil, 2Pharmacist, Master, INCA, Rio de Janeiro, Brazil, 3Physician, INCA, Rio de Janeiro, Brazil, 4AstraZeneca, Cotia, Brazil, 5AstraZeneca, Gaithersburg, MD, USA.
OBJECTIVES: Lung cancer (LC) is the leading cause of cancer mortality in Brazil, with approximately 75% of patients with advanced disease at the time of diagnosis. This study assesses the costs of LC from a Brazilian public reference hospital perspective.
METHODS: Retrospective cohort study of patients diagnosed with LC from March to May 2017, treated at the National Cancer Institute (INCA) and followed-up for up to five years. A bottom-up micro-costing method was applied, using the activity-based cost (ABC) approach. Resource data was obtained from medical charts and aggregated for confidentiality purposes. Unit costs were extracted from official databases: Health Price Bank (BPS) for drug and hospital supplies, SUS Management System (SIGTAP) for surgeries and medical tests and National Union of Federal Public Servants in Science and Technology (SINDCT) for human resources costs. Costs were converted from Brazilian currency (BRL) to US dollars (USD) (exchange rate: 1 USD = 0.19 BRL (06/2021)). This study was approved by the Research Ethics Committee (CAAE: 81711124.4.0000.5274).
RESULTS: From 161 patients identified, 81 were excluded from the study, mainly due to death before the final diagnosis. Among the remaining patients, 92.5% were diagnosed with Non-Small Cell Lung Cancer (NSCLC), majority were men (52.5%) and smokers or ex-smokers (45.0%). The most used treatment was chemotherapy alone or in combination with radiotherapy (55.0%). Direct costs were concentrated in the first two years of treatment (92.0%), averaging BRL 96,871.83 (USD 18,405.65) per patient. The costs for patients that progressed from stage I to III increased by 476 % compared to the cost of those who didn´t progress. Patients in IV-B stage had the highest average treatment cost at BRL 21,334.39 (USD 4,053.53) per month.
CONCLUSIONS: To reduce LC economic burden, investing in early diagnosis is essential, as average treatment costs per patient were lower in early stages.
METHODS: Retrospective cohort study of patients diagnosed with LC from March to May 2017, treated at the National Cancer Institute (INCA) and followed-up for up to five years. A bottom-up micro-costing method was applied, using the activity-based cost (ABC) approach. Resource data was obtained from medical charts and aggregated for confidentiality purposes. Unit costs were extracted from official databases: Health Price Bank (BPS) for drug and hospital supplies, SUS Management System (SIGTAP) for surgeries and medical tests and National Union of Federal Public Servants in Science and Technology (SINDCT) for human resources costs. Costs were converted from Brazilian currency (BRL) to US dollars (USD) (exchange rate: 1 USD = 0.19 BRL (06/2021)). This study was approved by the Research Ethics Committee (CAAE: 81711124.4.0000.5274).
RESULTS: From 161 patients identified, 81 were excluded from the study, mainly due to death before the final diagnosis. Among the remaining patients, 92.5% were diagnosed with Non-Small Cell Lung Cancer (NSCLC), majority were men (52.5%) and smokers or ex-smokers (45.0%). The most used treatment was chemotherapy alone or in combination with radiotherapy (55.0%). Direct costs were concentrated in the first two years of treatment (92.0%), averaging BRL 96,871.83 (USD 18,405.65) per patient. The costs for patients that progressed from stage I to III increased by 476 % compared to the cost of those who didn´t progress. Patients in IV-B stage had the highest average treatment cost at BRL 21,334.39 (USD 4,053.53) per month.
CONCLUSIONS: To reduce LC economic burden, investing in early diagnosis is essential, as average treatment costs per patient were lower in early stages.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE166
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Value of Information
Disease
SDC: Oncology