Añorve Bailon Denisse, Picó-Guzmán Javier, Cifuentes Sergio, Trejo Rogelio, Rodríguez Cid Jeronimo, Juarez-Vignon Whaley Juan Jose, Heredia Zepeda Alan Alexis, Gerson Raquel, Camacho-Limas Christian Patricio, Martínez-Herrera José Fabián, Molina Diana Bonilla, Camarín Sánchez Efraín, Shveid Gerson Daniela
ISSSTE, Centro Médico Nacional "20 de Noviembre", Ciudad de México, CDMX, México.
LifeSciences Consultants, Ciudad de México, Mexico.
Pharmacoecon Open. 2024 Nov;8(6):869-885. doi: 10.1007/s41669-024-00514-6. Epub 2024 Aug 6.
Lung cancer continues to be the leading cause of death among cancer patients worldwide. This study aimed to estimate the clinical, economic, and social burdens of stage IV non-small cell lung cancer (NSCLC) in private and public healthcare centers in Mexico, utilizing real-world evidence.
The study population included patients >18 years of age diagnosed with stage IV NSCLC who received cancer treatment at the Centro Médico Nacional Siglo XXI (IMSS), the Centro Médico Nacional "20 de Noviembre" (ISSSTE), the Mexican Institute of Respiratory Diseases (INER), and the Medical Center ABC (American British Cowdray) from 1 January 2019 to 31 December 2020. The analysis included evaluation of epidemiological data, treatment regimens, and clinical outcomes, and emphasized pharmacological and non-pharmacological treatments, including detailed follow-up investigations, as part of comprehensive clinical management. Additionally, the study assessed the social burden through variables such as working-age absenteeism and presenteeism and caregiver productivity loss, as well as economic burden, considering both clinical and social components, with costs adjusted to 2022 Mexican pesos (MXN) values.
A total of 188 patients with metastatic NSCLC were studied. The main type of NSCLC tumor found in the sample was adenocarcinoma (81%). Treatment regimens included pharmacological treatments (78%), non-pharmacological treatments (25%), and palliative care (24%). Complications were present in 73% of the cohort, while 60% presented adverse events. Clinical management costs of up to MXN1,001,579 per patient in the public sector and MXN2,140,604 in the private sector were reported. It was estimated that working-age patients lose 84-335 days yearly due to absenteeism and presenteeism, while caregivers report a productivity loss equivalent to 13-30 days due to the management of NSCLC patients. These indirect costs of NSCLC contribute to the social burden. A working-age patient with stage IV disease is associated with an average indirect cost of MXN49,731-178,287 in public institutions, while in private institutions, the cost elevates to MXN438,103.
This study highlights the substantial clinical, economic, and social burdens of stage IV NSCLC in Mexico, revealing significant disparities between public and private healthcare sectors. It underscores the urgent need for standardized practices and equitable care across all systems.
肺癌仍然是全球癌症患者的主要死因。本研究旨在利用真实世界证据，评估墨西哥公立和私立医疗中心IV期非小细胞肺癌（NSCLC）的临床、经济和社会负担。
研究人群包括2019年1月1日至2020年12月31日期间在墨西哥国立医学中心西格洛 XXI（IMSS）、墨西哥国立“11月20日”医学中心（ISSSTE）、墨西哥呼吸疾病研究所（INER）和ABC医疗中心（美英考德里）被诊断为IV期NSCLC并接受癌症治疗的18岁以上患者。分析包括对流行病学数据、治疗方案和临床结果的评估，并强调药物和非药物治疗，包括详细的随访调查，作为综合临床管理的一部分。此外，该研究通过诸如工作年龄缺勤和出勤主义以及照顾者生产力损失等变量评估社会负担，以及经济负担，同时考虑临床和社会因素，并将成本调整为2022年墨西哥比索（MXN）价值。
共研究了188例转移性NSCLC患者。样本中发现的NSCLC肿瘤主要类型为腺癌（81%）。治疗方案包括药物治疗（78%）、非药物治疗（25%）和姑息治疗（24%）。73%的队列出现并发症，60%出现不良事件。据报告，公共部门每位患者的临床管理成本高达1,001,579墨西哥比索，私立部门为2,140,604墨西哥比索。据估计，工作年龄患者每年因缺勤和出勤主义损失84 - 335天，而照顾者报告因管理NSCLC患者而生产力损失相当于13 - 30天。NSCLC的这些间接成本导致了社会负担。IV期疾病的工作年龄患者在公共机构的平均间接成本为49,731 - 178,287墨西哥比索，而在私立机构，成本升至438,103墨西哥比索。
本研究突出了墨西哥IV期NSCLC的巨大临床、经济和社会负担，揭示了公立和私立医疗部门之间的显著差异。它强调了在所有系统中迫切需要标准化做法和公平护理。
