OBJECTIVES : To estimate the disease burden of gastric cancer (GC) under the current treatment pattern in China.

METHODS : A decision-analytic model was constructed to simulate the Chinese patients with GC and the age and gender-matched Chinese general population over lifetime time horizon for the differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. A literature search was conducted to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of GC.

RESULTS : The Chinese GC patients were associated with reduced average overall survival by 8.305 years (10.918 years vs. 19.223 years), reduced average QALY by 8.530 QALY (8.617 QALY vs. 17.147 QALY), and increased average life-time direct medical costs by ¥132,945 (¥250,088 vs. ¥117,144). The reduced QALY associated with GC was sensitive to the risk of disease recurrence after radical gastrectomy (change: -1.387 QALY), stage III (change: -0.950 QALY) and IV GC (change: 0.828 QALY) at diagnosis, utility of early-stage GC (change: 0.879 QALY), and patient age (change: 0.835 QALY). The increased lifetime medical costs associated with GC was sensitive to medical costs of progression disease (change: ¥48,833), the mortality of progressive disease (change: ¥-47,938), radical gastrectomy rate (change: ¥18,276), and medical cost of radical gastrectomy (change: ¥17,653). The probabilistic sensitivity analysis with 5,000 Monte Carlo simulations estimated the median and 95% credible interval of reduced QALY (-8.473 QALY, -9.499 to -7.501 QALY) and increased lifetime direct medical costs ( ¥135,029, ¥110,720 to ¥164,844).

CONCLUSIONS : The disease burden of GC in Chinese patients was characterized by reduced overall survival, reduced QALY, and increased medical costs that were sensitive to GC stage distribution at diagnosis, utility of early-stage GC, radical gastrectomy, and the mortality and medical costs of progressive disease.