New drugs not major cost drivers for lung cancer care

Allison M. Bell, Mitra Corral, John R. Penrod, Ying Zhang, Christopher R. Frei, Laurajo Ryan, Mark E. Salvati, Jim M. Koeller

    Research output: Contribution to journalArticlepeer-review

    2 Scopus citations


    Objectives: Our objective was to characterize the direct cost of stage 4 non-small cell lung cancer (NSCLC) from 2000 to 2009, cost of disease segments (diagnosis, active treatment, end-of-life), cost impact of new therapies, and cost trend from 2003 to 2009. Study Design: We used the PharMetrics claims database to conduct a retrospective cohort study using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Methods: Patients 20 years and older with newly diagnosed metastatic NSCLC were included. The study period was divided into the pre (2000-2002), transition (2003-2005), and current (2006-2009) periods to account for incorporation of newer drugs (biologics, tyrosine kinase inhibitors, pemetrexed) into guidelines. Descriptive statistics (median), χ2 test, and Wilcoxan rank sum tests were used. We created multiple least squares regression models to adjust for baseline confounders. Results: Overall cost (n = 969) from 2000 to 2009 was $10,281 per patient per month (PPPM), with no difference between transition ($10,525 PPPM; n = 439) and current ($10,226 PPPM; n = 503) periods. Overall diagnosis cost was $6601 PPPM. Active treatment cost was $9287 PPPM. End-of-life cost was $12,215 PPPM. Drug cost was 23% of overall cost in transition and 21% in current. Gold standard cost (≥5 months active treatment; n = 316) was $144,147 per patient and $9371 PPPM. Comorbidities had no effect on cost. Conclusions: This study showed no significant change in cost from 2003-2009 in the treatment of stage 4 NSCLC. Individual newer agent costs did not appear to be primary drivers of treatment cost, contradicting the belief that newer cancer treatments are driving cost increase. However, drug cost still represented roughly 20% of cost for stage 4 NSCLC.

    Original languageEnglish (US)
    Pages (from-to)e50-e59
    JournalAmerican Journal of Pharmacy Benefits
    Issue number3
    StatePublished - Jan 1 2014

    ASJC Scopus subject areas

    • Business and International Management
    • Pharmacology, Toxicology and Pharmaceutics (miscellaneous)
    • Decision Sciences (miscellaneous)


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