Systematic Literature Review of the Economic Burden of Illness in Advanced or Metastatic Non-Small Cell Lung Cancer in First-Line
Author(s)
Divyan Chopra, PhD1, Vidhi Patel, MS2, Nadia Karim, MS3, Chukwuebuka Dominic Igbelina, MSc4, Thomas Macmillan, MS5, Ihtisham Sultan, PhD6, Björn Stollenwerk, PhD7.
1HEOR, Amgen, Thousand Oaks, CA, USA, 2Cytel Canada Health Inc., Toronto, ON, Canada, 3Amgen Ltd., Uxbridge, UK, Uxbridge, United Kingdom, 4Cytel Canada Health Inc., Vancouver, BC, Canada, 5Cytel Inc., London, UK, London, United Kingdom, 6Amgen Inc, Thousand Oaks, CA, USA, 7Amgen (EUROPE) GmbH, Rotkreuz, Switzerland.
1HEOR, Amgen, Thousand Oaks, CA, USA, 2Cytel Canada Health Inc., Toronto, ON, Canada, 3Amgen Ltd., Uxbridge, UK, Uxbridge, United Kingdom, 4Cytel Canada Health Inc., Vancouver, BC, Canada, 5Cytel Inc., London, UK, London, United Kingdom, 6Amgen Inc, Thousand Oaks, CA, USA, 7Amgen (EUROPE) GmbH, Rotkreuz, Switzerland.
OBJECTIVES: Lung cancer is the leading cause of cancer-related mortality worldwide with non-small cell lung cancer (NSCLC) accounting for 85% of cases and frequently diagnosed at advanced stages. The objective of this systematic literature review (SLR) is to provide a comprehensive overview of healthcare costs associated with advanced/metastatic (a/m) NSCLC treated in first-line (1L) setting.
METHODS: Searches were conducted in Embase, Medline, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews from January 2018 to March 2024, supplemented by grey literature searches. English-language articles reporting costs for a/m non-resectable 1L NSCLC from North America, Europe and Oceania were prioritized for extraction.
RESULTS: Data were extracted from 22 studies, with 17 studies primarily from the USA (n=17), with additional data from Italy (n=3), Spain (n=1), and Austria (n=1). In the US, per-patient per-month (PPPM) costs for 1L Medicare patients (n=3) ranged from $6,521 to $14,126, whereas those for commercially insured patients (n=17) ranged from $7,923 to $69,564 PPPM. The costs were mainly attributed to outpatient visits (n=4), inpatient hospitalizations (n=3) and drug costs (n=3) as the major drivers. Among studies evaluating commercially insured patients in the US, 83% reported higher costs for immunotherapy (IO) + chemotherapy ($32,436 to $69,564 PPPM) compared to chemotherapy ($10,950 to $39,738 PPPM) and IO alone ($17,763 to $45,047 PPPM). Similarly, IO + chemotherapy regimens were found to have the highest outpatient costs ($3,914 to $40,069 PPPM) compared to chemotherapy ($2,908 to $26,937 PPPM) and IO ($617 to $26,303 PPPM) alone (n=4). Due to the limited number of studies from other regions, no trends were observed in European or Oceania studies.
CONCLUSIONS: IO and chemotherapy combinations in 1L a/m NSCLC consistently posed a high economic burden despite variability in study designs, data sources and study period. These findings are important for healthcare payers for efficient resource allocation.
METHODS: Searches were conducted in Embase, Medline, Cochrane CENTRAL, and Cochrane Database of Systematic Reviews from January 2018 to March 2024, supplemented by grey literature searches. English-language articles reporting costs for a/m non-resectable 1L NSCLC from North America, Europe and Oceania were prioritized for extraction.
RESULTS: Data were extracted from 22 studies, with 17 studies primarily from the USA (n=17), with additional data from Italy (n=3), Spain (n=1), and Austria (n=1). In the US, per-patient per-month (PPPM) costs for 1L Medicare patients (n=3) ranged from $6,521 to $14,126, whereas those for commercially insured patients (n=17) ranged from $7,923 to $69,564 PPPM. The costs were mainly attributed to outpatient visits (n=4), inpatient hospitalizations (n=3) and drug costs (n=3) as the major drivers. Among studies evaluating commercially insured patients in the US, 83% reported higher costs for immunotherapy (IO) + chemotherapy ($32,436 to $69,564 PPPM) compared to chemotherapy ($10,950 to $39,738 PPPM) and IO alone ($17,763 to $45,047 PPPM). Similarly, IO + chemotherapy regimens were found to have the highest outpatient costs ($3,914 to $40,069 PPPM) compared to chemotherapy ($2,908 to $26,937 PPPM) and IO ($617 to $26,303 PPPM) alone (n=4). Due to the limited number of studies from other regions, no trends were observed in European or Oceania studies.
CONCLUSIONS: IO and chemotherapy combinations in 1L a/m NSCLC consistently posed a high economic burden despite variability in study designs, data sources and study period. These findings are important for healthcare payers for efficient resource allocation.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE343
Topic
Economic Evaluation
Disease
SDC: Oncology