Cortinovis Diego Luigi, Perrone Valentina, Giacomini Elisa, Sangiorgi Diego, Andretta Margherita, Bartolini Fausto, Taurino Giuseppe, Belfiore Marco, Sicari Emilia, Degli Esposti Luca
Division of Oncology, Department of Medicine and Surgery, San Gerardo Hospital, University of Milano-Bicocca, 20126 Monza, Italy.
CliCon S.r.l. Società Benefit, 40137 Bologna, Italy.
Pharmaceuticals (Basel). 2023 Feb 27;16(3):363. doi: 10.3390/ph16030363.
This real-world analysis aims to estimate the epidemiology and economic burden related to early-stage non-small-cell lung carcinoma (eNSCLC) in the clinical practice Italian setting. An observational analysis was performed using administrative databases linked to pathological anatomy data, covering around 2.5 mln health-assisted individuals. From 2015 to mid-2021, eNSCLC patients staged II-IIIA treated with chemotherapy after surgery were included. Patients were stratified into those presenting loco-regional or metastatic recurrence during follow-up and annualized healthcare direct costs covered by the Italian National Health System (INHS) were estimated. In 2019-2020, the prevalence of eNSCLC was 104.3-117.1/million health-assisted subjects, and the annual incidence was 38.6-30.3/million. Data projected to the Italian population estimated 6206 (2019) and 6967 (2020) prevalent and 2297 (2019) and 1803 (2020) incident cases. Overall, 458 eNSCLC patients were included. Of them, 52.4% of patients had a recurrence (5% loco-regional-recurrence, 47.4% metastatic-recurrence). Healthcare total direct costs/patient averaged EUR 23,607, in particular, in the first year after recurrence, costs averaged EUR 22,493 and EUR 29,337 in loco-regional and metastatic-recurrence patients, respectively. This analysis showed that about one-half of eNSCLC patients stage II-IIIA experience a recurrence, and in recurrence patients, total direct costs were almost two-fold those of no-recurrence patients. These data highlighted an unmet clinical need, as the therapeutic optimization of patients at early stages.
这项真实世界分析旨在评估意大利临床实践中与早期非小细胞肺癌（eNSCLC）相关的流行病学和经济负担。利用与病理解剖数据相关联的行政数据库进行了一项观察性分析，涵盖约250万接受医疗辅助的个体。纳入了2015年至2021年年中接受手术后化疗的II-IIIA期eNSCLC患者。将患者分为随访期间出现局部区域或远处转移复发的患者，并估算了意大利国家卫生系统（INHS）承担的年度医疗直接成本。2019-2020年，eNSCLC的患病率为每百万接受医疗辅助的受试者104.3-117.1例，年发病率为每百万38.6-30.3例。根据意大利人口数据推算，2019年和2020年的患病例数分别为6206例和6967例，新发病例数分别为2297例和1803例。总共纳入了458例eNSCLC患者。其中，52.4%的患者出现复发（5%为局部区域复发，47.4%为远处转移复发）。每位患者的医疗总直接成本平均为23,607欧元，特别是在复发后的第一年，局部区域复发和远处转移复发患者的成本分别平均为22,493欧元和29,337欧元。该分析表明，约一半的II-IIIA期eNSCLC患者会出现复发，且复发患者的总直接成本几乎是非复发患者的两倍。这些数据凸显了一项未满足的临床需求，即早期患者的治疗优化。
