OBJECTIVES The aim of this study was to describe the NSCLC patient journey, describing their demographics, clinical characteristics, resource utilization, access to services and outcomes in the Brazilian private health care system.

METHODS Retrospective cohort study based on three administrative database claims, which included advanced NSCLC cases, from 2011 to 2016. They were initially eligible if presented (lung cancer diagnosis, ICD-10 code 34 with stage III and IV and non-small cell histology). Data were collected on demographics, cancer-related information (staging, time from diagnosis to treatment), treatment related information (chemotherapy, surgery and radiotherapy), and resources used. The costs during hospital admission include hospital-related procedures. Survival analyses were performed to assess mortality per NSCLC stage.

RESULTS Out of 5,016 patients included, most of them presented stage IV disease (67%) and 33.7% were 60 to 69 years old. At diagnosis, 55% had an elementary school level education. After being admitted in the health system, patients took an average of 31 days to receive diagnosis, and in 44% of the cases, the clinical oncologist was the first professional to be consulted. After diagnosis, the median time to start treatment was 35 days and when admitted to hospital, patients stayed an average 7.4 days with a cost that ranged from R$ 1,012 to 30,818. The most common treatment modality was chemotherapy (32%) followed by chemotherapy plus radiotherapy (21%). Since the diagnosis median survival of stage III and IV NSCLC were, respectively, 7 months and 8 months after diagnosis.

CONCLUSIONS This study provides real-world evidence on stage III and IV NSCLC in the Brazilian private health care system, which has shown to have high number of metastatic disease diagnosis, high health care-related costs and low survival rates. There is room for improving NSCLC care by promoting earlier tumor detection and providing standard treatments, such as combinations of chemotherapies and immunotherapies.