Jovanoski Nick, Abogunrin Seye, Di Maio Danilo, Belleli Rossella, Hudson Pollyanna, Bhadti Sneha, Jones Libby G
F. Hoffmann-La Roche Ltd, Basel, Switzerland.
Mtech Access, Bicester, Oxfordshire, UK.
Pharmacoeconomics. 2023 Nov;41(11):1437-1452. doi: 10.1007/s40273-023-01295-2. Epub 2023 Jun 30.
Approximately 2 million new cases and 1.76 million deaths occur annually due to lung cancer, with the main histological subtype being non-small cell lung cancer (NSCLC). The costs and resource use associated with NSCLC are important considerations to understand the economic impact imposed by the disease on patients, caregivers and healthcare services.
The objective of this systematic literature review (SLR) is to provide a comprehensive overview of the available direct medical costs, direct non-medical costs, indirect costs, cost drivers and resource use data available for patients with early-stage NSCLC.
Electronic searches were conducted via the Ovid platform in March 2021 and June 2022 and were supplemented by grey literature searches. Eligible patients had early-stage (stage I-III) resectable NSCLC and received treatment in the neoadjuvant or adjuvant setting. There was no restriction on intervention or comparators. Publication date was restricted to 2011 onwards, and English language publications or non-English language publications with an English abstract were of primary interest. Due to the anticipation of many studies meeting the inclusion criteria, analyses were restricted to full publications from countries of primary interest (Australia, Brazil, Canada, China, France, Germany, Italy, Japan, South Korea, Spain, UK and the US) and those with > 200 patients. The Molinier checklist was applied to conduct quality assessment.
Forty-two full publications met the eligibility criteria and were included in this SLR. Early-stage NSCLC was associated with significant direct medical costs and healthcare utilisation, and the economic burden of the disease increased with its progression. Surgery was the primary cost driver in stage I patients, but as patients progressed to stage II and III, treatments such as chemotherapy and radiotherapy, and inpatient care became the main cost drivers. There was no significant difference in resource use between patients with early-stage disease. However, these data were heavily US-centric and there was a paucity of data relating to direct non-medical and indirect costs associated with early-stage NSCLC.
Preventing disease progression for patients with NSCLC could reduce the economic burden of NSCLC on patients, caregivers and healthcare systems. This review provides a comprehensive overview of the available cost and resource use data in this indication, which is important in guiding the decisions of policy makers regarding the allocation of resources. However, it also indicates a need for more studies comparing the economic impact of NSCLC in markets in addition to the US.
每年约有200万新增肺癌病例和176万人死于肺癌，主要组织学亚型为非小细胞肺癌（NSCLC）。与NSCLC相关的成本和资源使用情况是了解该疾病对患者、护理人员和医疗服务造成的经济影响的重要考量因素。
本系统文献综述（SLR）的目的是全面概述早期NSCLC患者可用的直接医疗成本、直接非医疗成本、间接成本、成本驱动因素和资源使用数据。
于2021年3月和2022年6月通过Ovid平台进行电子检索，并辅以灰色文献检索。符合条件的患者为早期（I-III期）可切除NSCLC患者，并在新辅助或辅助治疗环境中接受治疗。对干预措施或对照物没有限制。出版日期限制在2011年以后，主要关注英文出版物或带有英文摘要的非英文出版物。由于预计许多研究会符合纳入标准，分析仅限于来自主要国家（澳大利亚、巴西、加拿大、中国、法国、德国、意大利、日本、韩国、西班牙、英国和美国）的完整出版物以及患者人数超过200的研究。应用莫利尼尔检查表进行质量评估。
42篇完整出版物符合纳入标准并被纳入本SLR。早期NSCLC与显著的直接医疗成本和医疗资源利用相关，且疾病的经济负担随着病情进展而增加。手术是I期患者的主要成本驱动因素，但随着患者进展到II期和III期，化疗和放疗等治疗以及住院护理成为主要成本驱动因素。早期疾病患者之间的资源使用没有显著差异。然而，这些数据严重以美国为中心，与早期NSCLC相关的直接非医疗和间接成本的数据很少。
预防NSCLC患者的疾病进展可以减轻NSCLC对患者、护理人员和医疗系统的经济负担。本综述全面概述了该适应症中可用的成本和资源使用数据，这对于指导政策制定者在资源分配方面的决策很重要。然而，这也表明除美国外，还需要更多研究来比较NSCLC在不同市场的经济影响。
