OBJECTIVES: Patients with advanced NSCLC for whom antineoplastics are not suitable are usually treated individually with best supportive care (BSC). This research aims to estimate annual costs of BSC for these patients from the perspective of the Statutory Health Insurance (SHI) in Germany.

METHODS: Recommended measures for BSC were identified from the German development stage 3 (S3) guideline for lung cancer. The costs of these measures were estimated based on public German cost data.

RESULTS: The annual costs of the recommended measure are as follows: for drugs (analgesics, opioids, corticosteroids, bronchodilators, benzodiazepines, antidepressants, laxatives, bisphosphonates, denosumab, levodropropizine, metoclopramide, anticonvulsants) from 116.80€ to 2,023.88€, for radiotherapy 2,390.00€ and 5,888.51€, respectively (depending on regime), for palliative surgery 5,447.63€, for rehabilitation 3,660.20€ and for three further measures (psychotherapy, physical therapy, therapy with oxygen) from 756.60€ to 2,194.25€. Summing up the costs of these measures, the upper limit of annual costs is 27,838.81€. These costs do not include costs for inpatient palliative care or treatment in the terminal phase (approx. 400€ per day).

CONCLUSIONS: As BSC is provided individually to patients, the annual costs of BSC in Germany for patients with advanced NSCLC lay within a wide range from 0€ (less likely) to 27,838.81€. In order to estimate the costs of BSC more precisely, further research regarding the frequency of each recommended measure for BSC in Germany is needed.