Total chemotherapy cost in NSCLC across Europe: Distribution of cost factors observed in three randomised clinical trials

Abstract

7225 Background: Economic analysis of randomized trials and meta-analyses have demonstrated that platinum-based therapy increases survival in NSCLC and is cost effective. However, limited healthcare budgets in most EU healthcare systems are leading to measures to contain or control expenditure on a national or hospital level. The discussion of treatment cost is dominated by data on the cost of the cytotoxic agent, not the total treatment cost. However, for centres where the chemotherapy is administered and the adverse events are treated, total treatment cost per patient should be considered. The present study aimed to determine the percentage of chemotherapy agent to total average treatment cost per patients across the UK, Germany, France, Italy and Spain. Methods: A retrospective analysis based on three comparative randomised clinical trials with platinum doublets (Schiller et al., 2002, Comella et al., 2000, Scagliotti et al., 2002) was performed from the viewpoint of the respective healthcare systems (third-party payer). Only direct costs were included. Costs included chemotherapy, namely the cost of the novel agent, the platinum agent, administration, concomitant medications and all other cost items. The analysis excluded the costs for medical professionals and laboratory testing. The prices were from 2003. Results: Overall the cost of the chemotherapy agent as part of the total treatment cost was 60% and ranged from 47% (Italy) to 70% (Spain). The cost of administration varies considerably from 13% (Germany) to 35% (France). This difference may be based on the challenge to capture and quantify the cost items related to administration in a systematic way across different healthcare systems. Conclusion: The cost of chemotherapy agents represent on average 60% of the total cost of chemotherapy treatment in advanced NSCLC in 5 EU healthcare systems. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Lilly Eli Lilly