PCN96 Economic Burden of BRAIN Metastasis in NON SMALL CELL LUNG Cancer in South Korea: Nationwide Retrospective Cohort Study

Abstract

Economic burden of brain metastasis (BM) in non small cell lung cancer (NSCLC) patients is considerable, but there have been not enough studies about economic impact of BM in NSCLC patients. Thus, we aimed to identify the economic burden of BM among NSCLC patients in South Korea. We conducted a retrospective cohort study using National Health Insurance Service – National Sample Cohort (NHIS-NSC) database from January 1, 2002 to December 31, 2015. Patients who was newly diagnosed with stage ⅢB or Ⅳ NSCLC between January 1, 2003 and December 31, 2013 were included. The subjects were classified as BM patients when they had claims of brain metastasis at least 30 days after the date of first diagnosis of NSCLC. We calculated healthcare costs during the follow-up periods of patients with and without BM as per-patient-per-month (PPPM) cost. The generalized linear model (GLM) was conducted to assess the impact of BM on healthcare costs. Of 2,989 patients who were newly diagnosed stage ⅢB or Ⅳ NSCLC, 334 (11.2%) were classified as BM patients. The mean follow-up periods of patients without and with BM were 629 and 539 days, respectively. The PPPM costs were $2,063 in patients with BM and $1,046 in patients without BM. The GLM analysis showed that having BM increased PPPM cost by 2.05-fold (95% Confidence Interval [CI], 1.83-2.28). Moreover, compared to Charlson Comorbidity Index (CCI) score of 0, CCI score over 5 increased PPPM cost by 1.19-fold (95% CI, 1.06-1.35). The presence of brain metastasis imposes a significant economic burden on non small cell lung cancer patients with two-fold PPPM increase of healthcare costs. Policy makers in regulatory agency should consider the impact of BM to allocate the healthcare resources effectively.