BackgroundSmall cell lung cancer (SCLC), the most aggressive form of lung carcinoma, represents approximately 15% of all lung cancers; however, the economic and healthcare burden of SCLC is not well-defined.ObjectiveThe aim of this study was to explore the impact of SCLC on healthcare costs through a systematic literature review (SLR).MethodsUsing the OVID search engine, the SLR was conducted in PubMed, MEDLINE In–Process, EMBASE, EconLIT and the National Health Service Economic Evaluation Database (NHS EED). Searches were limited to studies published between January 2005 and 24 February 2016, and excluded preclinical studies. Additional internet-based searches were conducted. In total, 229 abstracts were retrieved and systematically screened for eligibility, with 17 publications retained.ResultsThe majority of publications provided data on limited and extensive disease of SCLC. The reported burden was categorised as direct costs and indirect costs, with the majority of the publications (n = 16) reporting on direct costs and one reporting on both direct and indirect costs. The only indirect costs reported for SCLC were lost productivity (premature mortality costs) and caregiver burden. Chemotherapy, diagnostic costs and treatment costs were identified as significant costs when managing SCLC patients, including the associated treatment costs such as hospitalisation, nurse visits, emergency room visits, follow-up appointments and outpatient care.ConclusionsSCLC and its treatment have a substantial impact on costs. The scarcity and heterogeneity of economic cost data negated meaningful cost comparison, highlighting the need for further research. Capturing the economic burden of SCLC may help patients and clinicians make informed treatment choices and improve SCLC management.

The comparable efficacy and lower acquisition costs of FP/FORM compared with FP/SAL make it a cost-saving option for the UK NHS for the treatment of asthma patients requiring combination maintenance therapy using a pMDI.

Background: Improved cancer care means that more patients are surviving longer, but there is a need to examine how well patients survive. We conducted an exploratory analysis of a new conceptual framework termed ‘quality of survival’ (QoS) that delineates the quality of patients’ experience.\ud Methods: This project included an electronic database search to investigate the survivorship landscape and to create a visual QoS map and semi-structured interviews with patients (n = 35), clinicians (n = 40), and payers (n = 7) to support the QoS map. QoS was discussed in the context of two tumor types, metastatic non-small cell lung cancer and metastatic melanoma.\ud Results: Despite increased long-term survival, no specific definition of QoS exists. Patients reported many impacts that affect QoS, clinicians viewed QoS as relevant to treatment decisions, and payers felt it could help communicate different aspects relevant to the patient. Four interconnected QoS dimensions were developed (quality of life, survival, side effects, and economic impact), which vary in importance along the care continuum.\ud Conclusion: QoS is a patient-centric concept that could help decision-making and patient communication. The QoS map could provide a framework to monitor patient experience and help patients frame what treatment attribute is most important to them at any point in the cancer continuum

was based on the average monthly salary in the UK. A conservative assumption was made about the increased risk of a productive day being lost -associated with level of patient satisfaction to their treatment -by calculating an approximate number of unscheduled hospitalisations that users of a new inhaler would experience in the previous 12 months relative to Spiriva® HandiHaler®. Patient satisfaction with their inhaler was based on inhaler features that relate to ease of use and ergonomics and compared Spiriva® HandiHaler® to an improved inhaler. Results: The frequency of unscheduled hospitalisations for the new inhaler and Spiriva® HandiHaler® users were calculated at 0.34 and 0.38, resulting in 68 and 76 productive days lost annually, respectively. The total annual societal cost per patient was € 9,851 with the new inhaler and € 10,891 with Spiriva® HandiHaler®. The new inhaler costs € 1,040 less per annum than Spiriva® Handihaler®. ConClusions: New inhalers with improved features have the potential to offer substantial societal cost savings in COPD compared with Spiriva® Handihaler®.

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