OBJECTIVES: In resected localized and locally advanced NSCLC patients, neoadjuvant and adjuvant chemotherapy can also be administered depending on stage of the disease and patients’ characteristics. As no burden data were available, the aim of this study was to generate real-world data on hospital costs in resected early-stage NSCLC patients to fill this information gap.

METHODS: A nationwide real-world retrospective study using hospital secondary data from the PMSI included adult-patients with non-metastatic NSCLC who underwent a first lung resection (index stay [IS]) in 2015 and followed from IS until end of 2020, last registered healthcare resource utilization or in-hospital death, whichever occurred first. Costs included hospital specialist visits, hospital stays, expensive drugs and admission to intensive care or emergency units. Costs per patients using collective perspective were described for IS and over follow-up [FU], by periods (without recurrence, with local recurrence [LR], and with distant recurrence [DR]) and by type of surgery (infralobar resection, lobectomy, bilobectomy and pneumonectomy).

RESULTS: In total, 8,688 patients underwent a first lung resection. Median FU was 63 months with 5-year overall survival of 66.8% and mean (±standard deviation) overall cost was €28,334 (±31,687) per patient over the FU. At IS, mean overall costs were €12,425 (±8,234) whatever the type of surgery and were €9,974 (±6,207) for infralobar resections, €12,310 (±8,023) for lobectomy, €14,041 (±9,596) for bilobectomy, and €14,863 (±10,066) for pneumonectomy. Mean monthly and overall costs per patient were €835 (±2,266) and €15,407 (±21,303), €1,677 (±2,852) and €21,349 (±19,683), and €4,607 (±6,051) and €33,119 (±29,042), during periods without recurrence, with LR, and with DR, respectively.

CONCLUSIONS: This study highlights the economic burden of resected early-stage NSCLC. Mean costs varied by type of surgery and increased after disease progression, especially in case of DR. Optimal patient management at an early stage may prevent or delay costly recurrences.