OBJECTIVES: To estimate the disease burden of non-small cell lung cancer (NSCLC) under the current treatment pattern in China.

METHODS: A decision-analytic model was constructed to simulate the Chinese patients with NSCLC and the age and gender-matched Chinese general population over lifetime time horizon for the differences in overall survival, quality-adjusted life years (QALY), and lifetime direct medical costs. A literature search was conducted to identify appropriate evidence to estimate the model variables. Base case analysis and sensitivity analysis were conducted for the point estimations and uncertainty of the disease burden of NSCLC.

RESULTS: The Chinese NSCLC patients were associated with reduced average overall survival by 17.111 years (3.859 years vs. 20.970 years), reduced average QALY by 14.939 QALY (2.709 QALY vs. 17.649 QALY), and increased average life-time direct medical costs by ¥147,109 (¥274,251 vs. ¥127,143) under current treatment pattern. The reduced QALY associated with NSCLC was sensitive to the risks of distant metastasis associated with stage II NSCLC (change: -0.705 QALY) and stage I NSCLC (change:-0.423 QALY), advanced NSCLC proportion at diagnosis (change:- 0.568 QALY), and radical surgery rate (change: -0.520). The increased lifetime direct medical costs associated with NSCLC was sensitive to the mortality after the treatment failure with clozotinib (change: ¥-32,649), treatment effects of clozotinib (Change: ¥-32,065), and advanced NSCLC proportion at diagnosis (change: ¥-23,853). The probabilistic sensitivity analysis with 5,000 Monte Carlo simulations estimated the median and 95% credible interval of reduced QALY ( -15.168 QALY, -16.072 to -14.263 QALY) and increased lifetime direct medical costs (¥160,604, ¥119,079 to ¥218,626).

CONCLUSIONS: The disease burden of NSCLC in Chinese patients was characterized by reduced overall survival, reduced QALY, and increased medical costs that were sensitive to risk of distance metastasis, radical surgery rate, advanced NSCLC proportion at diagnosis, and clozotinib treatment for advanced NSCLC.