OBJECTIVES

This study sought to evaluate the real-world direct healthcare costs of metastatic non-small cell lung cancer (mNSCLC) patients by line of therapy prior to the availability of immunotherapies.

METHODS

Patients who received anti-cancer systematic treatment (Doublet chemotherapy, monochemotherapy, or Tyrosine-kinase inhibitors) for mNSCLC at IRST, Italy, from January 2014 to June 2017 were included in this retrospective analysis. Costs were evaluated during (1) first-line and (2) second-line therapy. Duration of each line was evaluated from the start of treatment to the earliest occurrence among (a) start of a new agent (b) a gap of > 42 days with no treatment (c) death (d) end of study period (December 31, 2017). The analysis was conducted from the National Health System perspective. Total costs were estimated including hospitalizations, outpatient visits, diagnostic exams, and systematic anti-cancer drugs. The mean cost per-patient-per-month (PPPM) was reported separately for first-line and second-line therapy.

RESULTS

A total of 352 patients were followed for a mean time of 180 and 143 days in the pre-treatment and first-line periods, respectively. A total of 111 patients were followed for a mean time of 106 days in the second-line period. Mean total healthcare costs were 2805€ (range:197-13962€) and 3,046€ (range:78-5105€) PPPM in the first and second line periods, respectively. These costs were mainly driven by treatment (29% in the first-line and 22% in the second line periods) and hospitalization costs (40% in the first-line and 57% in the second-line periods).

CONCLUSIONS

Based on real-world data, PPPM total health care costs of pre-treatment, first- and second-line tended to be similar for NSCLC population prior to IO approval in Italy. Financial support for this study was provided by Merck Sharp & Dohme Corp., a subsidiary Merck & Co., Inc., Kenilworth, NJ.