OBJECTIVES: Treatment landscape in metastatic lung cancer is quickly evolving, including targeted therapies and immunotherapies. Both treatments have shown improved survival but are also associated with increased costs. This study aimed to describe the evolution of costs associated with metastatic lung cancer in France.

METHODS: From the French national claims database (SNDS), a dynamic cohort of patients identified between 2013 and 2019 with metastatic lung cancer and a marker for the presence of metastases (ICD-10 code or at least one reimbursement for Bevacizumab or Pemetrexed) was constituted. Healthcare resource use was described each year through the percentage of patients with at least one record for each expenditure item. The trend in total mean monthly cost over the study period was studied using Joinpoint software.

RESULTS: Between 2013 and 2019, 116 686 patients with a metastatic lung cancer were identified (67.1% of men, median age of 65 years). The percentage of patients with at least one overnight hospitalization decreased from 85.2% in 2013 to 67.6% in 2019 while the use of day hospitalizations remained stable (about 40%). Between 2013 and 2019, the percentage of patients with outpatient care increased: medical visits (from 82.6% to 88.0%), lab tests (from 74.1% to 83.5%), medical procedures (from 72.0% to 83.2%). The total mean monthly cost per patient decreased (from 5,683€ to 4,653€), by 2.85% per year (95%CI: -4.13 to -1.56, p<0.0001). An increase in drugs acquisition costs (from 1,015€ to 1,365€) and a decrease in overnight hospitalizations costs (from 3,110€ to 1,990€) were observed.

CONCLUSIONS: This study highlights that the increase in drugs acquisition costs has been offset by a decrease in hospitalization costs, resulting in a decrease in global management costs of patients with metastatic lung cancer in France between 2013 and 2019. These findings may be the result of French health policy and/or improved disease management.