Presentation (CTI)

OBJECTIVES: Metastatic non-small cell lung cancer (mNSCLC) contributes a significant disease and economic burden. Over the past decade, treatment has evolved with introduction of EGFR- and ALK-targeted and immune-oncology (IO) drugs. However, limited evidence exists on the long-term costs of mNSCLC treatments in Sweden.
METHODS: This population-based retrospective study used data from the National Board of Health and Welfare, identifying patients who were initially diagnosed with stage IV NSCLC between 2011 and 2020. Patients who were initially diagnosed with stage I - III disease but later progressed to stage IV were not included. Healthcare costs, including inpatient care, outpatient care, and drug expenses, were assessed using Diagnosis-Related Group (DRG) tariffs and prescription data. Drug expenses exceeding DRG tariff limits such as IO drugs, were accounted for separately based on the retail list prices. Costs were analysed over five years post-diagnosis and adjusted to 2023 values.
RESULTS: A total of 17,107 patients were included. IO drug use increased sharply after 2016, becoming the predominant therapy in recent years while EGFR- and ALK-targeted drug uses steadily increased. Overall costs rose over time, particularly in the first year after diagnosis. The first-year mean cost was highest among the patients who received IO drugs within the first year after diagnosis (€105,287), primarily due to drug acquisition, but declined significantly in subsequent years. ALK- and EGFR-targeted therapies also incurred high initial costs but remained stable in subsequent years.
CONCLUSIONS: This study highlights the increasing economic burden of mNSCLC treatment in Sweden, driven by the introduction of the innovative therapies. While ALK- and EGFR-targeted and IO drugs contribute to high first-year mean costs, IO drug costs decline significantly in subsequent years after diagnosis.