OBJECTIVES: This study aims to evaluate trends and changes in costs incurred during the last year of life among lung cancer patients in Germany from 2014-2018. METHODS: Costs were analyzed using claims data from a German statutory health insurance fund (AOK PLUS), including patients who were deceased between 01/01/2014 and 31/12/2018, and who had one inpatient diagnosis and/or two confirmed outpatient diagnoses of lung cancer (using either ICD-10 code C33 or C34) within 365 days of their death. Average costs during last year of life were evaluated across five cohorts, consisting of patients who died in each observational year from 2014-2018. RESULTS: The claims dataset included 10,435 individuals (28.94% female) with a mean death age of 72.95 years and an average CCI score of 11.32 within the two-year period preceding their death; stable sample sizes and sociodemographic characteristics were observed across cohorts. In 2014, the average cost per patient in the last year of life was 25.837,62€ compared to 32.712,80€ in 2018. Over five years of observation, there was a 27% rise in the total average cost, with observed increases across all costing categories, including hospitalizations (26%), outpatient medications (35%), outpatient care (3%), rehabilitation stays (47%), and aids and remedies (26%). Spending patterns were comparable across time cohorts. Hospitalizations costs—ranging from 67% to 70% of total annual expenditures—accounted for most health-related spending, followed by outpatient prescriptions (20-23%), outpatient care (5-6%), inpatient rehabilitation stays (0-1%), and aids and remedies (4-5%). CONCLUSIONS: Average costs in the last year of life among lung cancer patients in Germany were approximately 32.712,80€ in 2018 and have been growing rapidly over the past five years, due to higher hospitalization and outpatient medication costs. Palliative care, versus systemic treatment of these patients, needs to be discussed more intensively, from an ethical, clinical, and health-economic perspective.