The Impact of Molecularly Targeted Treatment on Direct Medical Costs in Patients with Advanced Non-small Cell Lung Cancer
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Purpose To investigate the impact of targeted treatment on direct medical costs of patients withadvanced non-small cell lung cancer (NSCLC). Materials and MethodsMedical records of 108 stage IIIB/IV NSCLC patients treated in Seoul National UniversityHospital between 2003 and 2009, were reviewed to collect medical resources utilizationdata from the diagnosis of stage IIIB/IV NSCLC to the end of active anti-cancer treatment. The direct medical costs were calculated by multiplying the number of medical resourcesused by the unit price. All costs were expressed in US dollars for each patient. ResultsThe mean total direct medical costs were $34,732 (standard deviation, 21,168) in the studycohort. The mean total direct medical costs were higher in epidermal growth factor receptor(EGFR) mutation (EGFR MT)–positive patients than EGFR wild-type (EGFR WT) patients($41,403 vs. $30,146, p=0.005). However, the mean monthly direct medical costs did notdiffer significantly between EGFR MT–positive patients and EGFR WT patients ($2,120 vs. $2,702, p=0.119) because of the longer duration of active anti-cancer treatment in EGFRMT–positive patients. This discrepancy was mainly attributable to EGFR MT–positivepatients’ lower non-chemotherapy costs ($948 vs. $1,522, p=0.007). The total and monthlydirect medical costs of ALK fusion–positive patients who did not receive ALK inhibitors didnot differ from WT/WT patients. ConclusionThis study suggests that the availability of targeted agents for EGFR MT–positive patientslowers the mean monthly medical costs by prolonging survival and diminishing the use ofother medical resources, despite the considerable drug costs.
Abstract
Purpose To investigate the impact of targeted treatment on direct medical costs of patients withadvanced non-small cell lung cancer (NSCLC). Materials and MethodsMedical records of 108 stage IIIB/IV NSCLC patients treated in Seoul National UniversityHospital between 2003 and 2009, were reviewed to collect medical resources utilizationdata from the diagnosis of stage IIIB/IV NSCLC to the end of active anti-cancer treatment. The direct medical costs were calculated by multiplying the number of medical resourcesused by the unit price. All costs were expressed in US dollars for each patient. ResultsThe mean total direct medical costs were $34,732 (standard deviation, 21,168) in the studycohort. The mean total direct medical costs were higher in epidermal growth factor receptor(EGFR) mutation (EGFR MT)–positive patients than EGFR wild-type (EGFR WT) patients($41,403 vs. $30,146, p=0.005). However, the mean monthly direct medical costs did notdiffer significantly between EGFR MT–positive patients and EGFR WT patients ($2,120 vs. $2,702, p=0.119) because of the longer duration of active anti-cancer treatment in EGFRMT–positive patients. This discrepancy was mainly attributable to EGFR MT–positivepatients’ lower non-chemotherapy costs ($948 vs. $1,522, p=0.007). The total and monthlydirect medical costs of ALK fusion–positive patients who did not receive ALK inhibitors didnot differ from WT/WT patients. ConclusionThis study suggests that the availability of targeted agents for EGFR MT–positive patientslowers the mean monthly medical costs by prolonging survival and diminishing the use ofother medical resources, despite the considerable drug costs.
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