The Cost of Lung Cancer Management in France from the Payor's Perspective

Authors: Vergnenègre, Alain¹; Molinier, Laurent²; Combescure, Christophe³; Daurès, Jean-Pierre³; Housset, Bruno⁴; Chouaïd, Christos⁵

Source: Disease Management & Health Outcomes, Volume 14, Number 1, 2006 , pp. 55-67(13)

Publisher: Adis International

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Abstract:

Background: We assessed the average management cost per case of lung cancer in France according to the histological type and stage at diagnosis, together with the cost of each component of different treatment strategies.

Methods: The sample was drawn from public and private hospitals that were treating large numbers of patients. The study covered the period from 1 July 1998 to 30 June 1999 and was based on medical chart review. A Markov model with six decision trees (two for small cell lung cancer [SCLC] and four for non-small cell lung cancer [NSCLC]) was used for the cost analysis. Treatment was broken down into first-line and second-line strategies, surveillance, and terminal care (TC).

Results: The average management costs were euro22 006 (euro10 631–36 296) for 1 year and euro25 643 (euro10 631–41 191) for 2 years. The 2-year average costs were euro22 420 for disseminated SCLC and euro27 098 for localized SCLC. The costs of NSCLC ranged from euro19 543 for nonsurgical stages to euro30 024 for surgical stages and euro24 383 for stage IV. The weight of the different components of each strategy differed markedly according to the diagnostic subgroup: the cost of diagnosis ranged from 7.4% to 14% of total management costs, and that of TC from 11.5% to 31.1%. The principal cost component was first-line chemotherapy (32–58.5%). Sensitivity analyses showed that, whatever the type of lung cancer, the percentage of actively treated patients was the main cost determinant. TC and chemotherapeutic lines also had important economic implications.

Conclusion: The model developed here enables the component costs of different lung cancer management strategies in France to be assessed and the economic consequences of new treatment modalities to be predicted.

Keywords: Lung cancer; Markov model; Non small cell lung cancer; Small cell lung cancer

Document Type: Research article

Affiliations: 1: 1 Service de l'information Médicale et de l'Evaluation, Service de Pneumologie, Hôpital Cluzeau Limoges, Limoges, France 2: 2 Laboratoire de Santé Publique et d'Epidémiologie, Inserm U558, Faculté de Médecine, Toulouse, France 3: 3 Institut Universitaire de recherche clinique, Faculté de Médecine de Montpellier, Montpellier, France 4: 4 Service de Pneumologie, Centre hospitalier Intercommunal, Créteil, France 5: 5 Service de Pneumologie, Hôpital Saint Antoine, Paris, France

Publication date: 2006-01-01

The Cost of Lung Cancer Management in France from the Payor's Perspective

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