Healthcare costs in patients with metastatic lung cancer receiving chemotherapy

Sue Gao,Andrew Glass,Gerry Oster,Rohit Borker,Derek Weycker,Beth Barber,Montserrat Vera-Llonch

doi:10.1186/1472-6963-11-305

Abstract

BackgroundTo characterize healthcare resource utilization and costs in patients with metastatic lung cancer receiving chemotherapy in the US.MethodsUsing data from a large private multi-payer health insurance claims database (2000-2006), we identified all patients beginning chemotherapy for metastatic lung cancer. Healthcare resource use (inpatient, outpatient, medications) and costs were tallied over time from date of therapy initiation ("index date") to date of disenrollment from the health plan (in most instances, presumably due to death) or the end of the study period, whichever occurred first. Healthcare utilization and costs were characterized using Kaplan-Meier sample average methods.ResultsThe study population consisted of 4068 patients; mean (SD) age was 65 (11) years. Over a median follow-up of 334 days, study subjects averaged 1.5 hospital admissions, 8.9 total inpatient days, and 69 physician office and hospital outpatient visits. Mean (95% CI) cumulative total healthcare costs were $125,849 ($120,228, $131,231). Costs of outpatient medical services and inpatient care constituted 34% and 20% of total healthcare costs, respectively; corresponding estimates for outpatient chemotherapy and other medication were 22% and 24%.ConclusionOur study sheds additional light on the burden of metastatic lung cancer among patients receiving chemotherapy, in terms of total cost thru end of life as well as component costs by setting and type of service, and may be useful in informing medical resource allocation in this patient population.

Highlights

IntroductionMore than 45% of all patients with incident lung cancer present with advanced disease [2]; median survival time among these patients ranges from 8 to 13 months [3]
To characterize healthcare resource utilization and costs in patients with metastatic lung cancer receiving chemotherapy in the US
Healthcare Utilization Seventy-two percent of patients were admitted to an acute-care hospital at least once; the mean number of hospital admissions was 1.5, and the mean number of total inpatient days was 8.9 (Table 2)

Summary

Introduction

More than 45% of all patients with incident lung cancer present with advanced disease [2]; median survival time among these patients ranges from 8 to 13 months [3]. In 2004, costs of care in patients with lung cancer were estimated to account for approximately 20% ($4.2 billion) of all Medicare expenditures for the treatment of cancer, a figure that is greater than the estimated total. Systemic chemotherapy–often in combination with targeted therapies, such as bevacizumab–is currently the preferred treatment strategy [5] for lung cancer patients with non-squamous histology. Such treatment typically produces only modest improvements in survival and symptom palliation. Median survival among patients receiving bevacizumab–the most efficacious treatment at this time–is about 12 months

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Results

Discussion

Conclusion