BACKGROUND: Brain metastases (BMs) are highly prevalent among patients with anaplastic lymphoma kinase positive (ALK+) non-small cell lung cancer (NSCLC). No study had been published in regarding to the real-world economic burden of BMs in patients with ALK+NSCLC in China.

OBJECTIVES: To estimate the real-world economic burden of BMs in patients with ALK+NSCLC in China.

METHODS: A retrospective cohort study was conducted by pooling real-world data (RWD) from healthcare institutions located in eastern, central and southern China (January 2020 - September 2023). Adult patients diagnosed with ALK+ NSCLC and BMs were identified.To assess post-BM economic burden, the cohort included patients enrolled at least one month before and after the BM diagnosis date. Healthcare costs and resource utilization were assessed based on per-patient-per-month (PPPM) respectively.

RESULTS: 280 patients were identified eligible for selection criteria,among whom 50.7% were male,and the mean (standard deviation, SD) age was 55.0 (11.0) years (range 25-82 years). The median PPPM cost before BM occurrence was $2,677.8 (interquartile range, IQR: $1,402.7-$5,162.4), whereas it escalated to $4,512.3 (IQR: $2,419.1-$7,148.1) after BM, marking a 67.1% increase. Post-BM costs were driven by drugs (49.3%), treatment-related services (21.0%) , physical examination and laboratory (19.5%), medical consumables (7.4%), and nursing care (1.1%). Patients’ resource utilization increased significantly in post-BM status, with a 64.5% increase in outpatient visits and a 32.7% increase in inpatient stays.

CONCLUSIONS: Patients with ALK+ NSCLC who developed BMs incur a significantly higher economic burden and contribute to an increased consumption of healthcare resources in selected regions of China .These results highlight the need for 1L therapeutic strategies to delay or prevent BM occurrence and to lessen its burden among patients with ALK+ NSCLC.