Measuring the indirect cost associated with advanced non-small cell lung cancer: a nationwide cross-sectional study in China

Abstract

Purpose This study was conducted to estimate the indirect cost of locally advanced and metastatic non-small cell lung cancer (NSCLC) without sensitizing EGFR and ALK alterations in China and explore the predictors from both patient and caregiver perspectives. Methods Data were obtained from a nationwide cross-sectional study for the patients with advanced NSCLC (stage IIIB–IV) and their caregivers. Indirect medical cost was estimated as health productivity loss based on self-reported income and loss of work time. The generalized linear model was used to assess the independent associations between statistically significant variables and indirect economic burden. Results 611 pairs of patients and patient caregivers from 13 medical centers in five provinces in China participated in this investigation. The indirect medical cost associated with advanced NSCLC since the patient diagnosed was $1413 per capita in China. General linear regression results showed that the indirect medical cost was significantly influenced by duration of disease since diagnosis, treatment options, caregivers’ occupation and age (P < 0.05). Conclusion The indirect economic burden linked to advanced NSCLC in China is considerable on patients, and their caregivers. To minimize the severe challenges of indirect economic burden related to advanced NSCLC, expanding the coverage of the medical insurance and assistance system to reimburse part of the indirect costs related to cancer, as well as strengthening the accessibility for more effective therapies to improve the prognosis of advanced NSCLC, and further promote the patients and their caregivers to return to work or normal life may be the potentially feasible approaches.

Does pathologic type shape the hospitalization costs of advanced non- small cell lung cancer patients? A multicenter real-world data study

“…Compared to general hospitals, patients hospitalized in specialized hospitals had higher costs, potentially indicating that more innovative but expensive treatments are more popularized in specialized hospitals (34). Also, patients who received treatment in other departments rather than in oncology and in respiratory were more likely to spend more during hospitalization, which may explain that the professional treatment is bene cial to cost-saving (5). Non-squamous carcinoma patients exhibit greater differences in coe cients and bigger impact on costs across different hospital types and departments compared to the squamous carcinoma patients.…”

“…It is estimated that 85-90% of lung cancer patients present with nonsmall cell cancer (NSCLC) (2,3). A majority of patients are diagnosed with advanced or metastatic NSCLC(4) resulting in poor prognosis (4) and heavy disease burden due to the negative impact on disability, poor health-related quality of life, and signi cant nancial burden (5,6).…”

A latent class analysis of resilience and its association with patient-reported symptoms in patients with esophageal cancer after esophagectomy

“…Cancer patients, especially those in rural areas, are relatively poor, and the current health insurance system in China does not completely relieve the burden of medical expense ( Xia et al, 2023 ), Excessive medical cost would aggravate patients’ family economic burden, imposing a sense of powerlessness, thereby weakening resilience and leading to varying severity of psychological distress. So, reducing medical expense and increasing the scope of medical assistance and insurance system coverage ( Yang et al, 2022 ), as well as strengthening the accessibility of health care ( Wang et al, 2022 ), may be potentially feasible approaches to reduce the negative impact of poor socioeconomic position. In addition, patients aged 66–70 years exhibited higher levels of resilience and were more likely to be able to cope with their disease successfully.…”

Cost-Effectiveness of First-Line Atezolizumab versus Chemotherapy in Non-Small-Cell Lung Cancer Patients Ineligible for Platinum-Containing Regimens

“…Its annual cost in China exceeds the per capita GDP in China by 3.73 times. 17 With 1060,600 new cases of advanced lung cancer diagnosed annually in China, approximately 328,000 individuals are not suitable candidates for platinum-containing regimens. 18 This sizable population represents a significant group that could potentially benefit from atezolizumab treatment.…”