OBJECTIVES:

Lung cancer is the leading cause of cancer death and the most common cancer type in China. The objective of the literature review was to summarize the economic burden of lung cancer in China and identify data gaps for future research.

METHODS:

A systematic literature review was conducted. Economic studies reporting direct or indirect costs were included. Four databases (EMBASE, MEDLINE, EconLit and NHS EED) were searched. The search strategies utilized a combination of disease and economic impact indexed terms and free texts. The searches were limited to studies relevant to China and published since 2015.

RESULTS:

Overall, 465 references were searched, and 37 references were included. Thirty-four were observational studies using real-world data and four were clinical trials. The most common data sources were hospitals, followed by insurances, surveys, national databases, bureau of statistics, etc. Ten were national studies. Twenty-four and 13 studies examined all types of lung cancer and non-small cell lung cancer (NSCLC) only respectively.

Thirty-four, one, and two studies reported direct, indirect and both costs. The total direct medical cost increased from US$3.03 billion annually from 2013-2016 to US$10.3 billion in 2017. The total indirect cost due to productivity losses resulted from premature deaths increased from US$5.5 billion in 2012 to US$12.5 billion in 2017. Moreover, the overall expenditure per lung cancer patient increased from approximately US$7600 from 2005 to 2011 to US$10,400 from 2012 to 2014.

The major hospitalization expenses were in tertiary hospitals or eastern region of China. Smoking, SO₂ emissions and comorbidities also contributed to the economic burden of lung cancer.

CONCLUSIONS:

The economic burden of lung cancer increased substantially in the past decade in China. Meanwhile, there is limited evidence in indirect cost or by the type of lung cancer. Further real-world studies should be conducted to fill the gap.