Lin Chien-Yu, Wu Tzu-I, Yang Szu-Chun
Division of Thoracic Medicine, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Clinicoecon Outcomes Res. 2024 Oct 19;16:761-769. doi: 10.2147/CEOR.S489783. eCollection 2024.
This study aimed to estimate the costs associated with adverse events (AEs) in advanced lung cancer patients treated with first-line therapies.
All patients with advanced lung cancer diagnosed between 2011 and 2019 were identified from the Taiwan National Cancer Registry. First-line treatment was defined as a therapy that began within 30 days before and 90 days after the diagnosis. We defined a newly-developed AE as one established after first-line treatment had commenced, with the contingency that the patient had not been diagnosed with the AE within one year prior to the outset of therapy. One patient with a specific AE was matched on age, sex, and regimens with four patients without the AE. Payments incurred over the same period of time in the two groups were compared to estimate the AE-related costs.
A total of 27,376 patients receiving first-line targeted therapy, immunotherapy, or chemotherapy were identified. Clinical characteristics of 15,454 treatment episodes with a specific AE and 61,816 treatment episodes without the AE were well balanced. The costliest AEs of any severity were sepsis/septicemia, neuropathy, and acute kidney injury, with the respective average incremental costs of 10101, 9982, and 7839 USD. The costliest severe AEs requiring hospitalization were sepsis/septicemia, interstitial lung disease/pneumonitis, and neuropathy, with mean incremental costs of 22483, 10645, and 10120 USD, respectively.
Costs associated with AEs in advanced lung cancer patients treated with first-line therapies were substantial. These estimates could be adopted for future cost-effectiveness analyses of new lung cancer treatments.
本研究旨在估算接受一线治疗的晚期肺癌患者发生不良事件(AE)的相关成本。
从台湾地区癌症登记处识别出2011年至2019年间确诊的所有晚期肺癌患者。一线治疗定义为在诊断前30天内及诊断后90天内开始的治疗。我们将新发生的AE定义为在一线治疗开始后确诊的AE,前提是患者在治疗开始前一年内未被诊断出患有该AE。将一名患有特定AE的患者与四名未患该AE的患者按年龄、性别和治疗方案进行匹配。比较两组在同一时期产生的费用,以估算与AE相关的成本。
共识别出27376名接受一线靶向治疗、免疫治疗或化疗的患者。15454例发生特定AE的治疗事件和61816例未发生AE的治疗事件的临床特征达到良好平衡。任何严重程度的最昂贵AE为败血症/脓毒症、神经病变和急性肾损伤,各自的平均增量成本分别为10101美元、9982美元和7839美元。需要住院治疗的最昂贵严重AE为败血症/脓毒症、间质性肺疾病/肺炎和神经病变,平均增量成本分别为22483美元、10645美元和10120美元。
接受一线治疗的晚期肺癌患者发生AE的相关成本巨大。这些估算结果可用于未来肺癌新治疗方法的成本效益分析。