OBJECTIVES: From 2014 to 2021, 25 pharmacological treatments for lung cancer, received a positive price and reimbursement decision in the Spanish National Health Service. The Catalan Health Service (a regional health care institution of Spain), is responsible for resource allocation, budget planning, and policy development to ensure equitable and efficient access throughout Catalonia. The aim of the study is to describe trends in medicine utilization for treating lung cancer and its expenditure in the Catalan Health Service.

METHODS: We conducted a retrospective descriptive analysis of medicine use for lung cancer patients in Catalonia. We identified patients diagnosed with lung cancer (International Classification of Diseases, 10th revision-ICD-10-C34) from 2014 to 2021, treated with systemic medicines and the expenditure of their use. We analyse treatments use by therapeutic groups (chemotherapy, targeted therapy, immunotherapy, antiangiogenic therapies and others) drawing from health care registries data in Catalonia.

RESULTS: The number of patients who received any pharmacological treatment increased from 2014 (n=2,161) to 2021 (n =3,873), although new diagnoses of lung malignancy remained stable (n = 4,366 in 2014 and n = 4,447 in 2021). The pharmaceutical expenditure showed an upward trend with aggregate values of €9.4 million in 2014 and €48.5 million in 2021. The percentage of patients who received immunotherapy represented to nearly 35% of the total patients treated with any systemic medicine in 2021, with an expenditure of € 23.3 million (48% of the total pharmaceutical spending for lung cancer).

CONCLUSIONS: The steady rise in reimbursement of multiple biomarker-targeted treatments, mainly due to the immunotherapy, have incurred with a high on the extent use and spending on lung cancer treatment in Catalonia. In the coming years, an increase in pharmaceutical spending for treating lung cancer is expected to escalate with the approval of new pharmacological treatments, inclusion of regimens with multiple innovative, but expensive medicines and longer duration of treatment.