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

  • Original Research Article
  • Published:
Disease Management & Health Outcomes

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 €22 006 (€10 631–36 296) for 1 year and €25 643 (€10 631–41 191) for 2 years. The 2-year average costs were €22 420 for disseminated SCLC and €27 098 for localized SCLC. The costs of NSCLC ranged from €19 543 for nonsurgical stages to €30 024 for surgical stages and €24 383 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.

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Acknowledgments

This study was supported by an educational grant from Aventis Pharmaceuticals, France. The authors have no conflicts of interest that are directly relevant to the content of this study.

We thank all the clinicians who helped us to collect data for this study (J.M. Bachaud, P. Bombaron, J.Y. Douillard, A. Monnier, G. Ozenne, R. Poirier, E. Quoix, F. Reboul, O. Rixe, G. Robinet, T. Urban). We also thank M.P. Schuller-Lebeau for his invaluable help.

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Authors and Affiliations

  1. Service de l’information Médicale et de l’Evaluation, Service de Pneumologie, Hôpital Cluzeau Limoges, Limoges, France

    Alain Vergnenègre (Professor of Epidemiology and Health Economics)

  2. Faculté de Médecine, Laboratoire de Santé Publique et d’Epidémiologie, Inserm U558, Toulouse, France

    Laurent Molinier

  3. Faculté de Médecine de Montpellier, Institut Universitaire de recherche clinique, Montpellier, France

    Christophe Combescure & Jean-Pierre Daurès

  4. Service de Pneumologie, Centre hospitalier Intercommunal, Créteil, France

    Bruno Housset

  5. Service de Pneumologie, Hôpital Saint Antoine, Paris, France

    Christos Chouaïd

Authors
  1. Alain Vergnenègre
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  2. Laurent Molinier
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  3. Christophe Combescure
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  4. Jean-Pierre Daurès
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  6. Christos Chouaïd
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Correspondence to Alain Vergnenègre.

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Vergnenègre, A., Molinier, L., Combescure, C. et al. The Cost of Lung Cancer Management in France from the Payor’s Perspective. Dis-Manage-Health-Outcomes 14, 55–67 (2006). https://doi.org/10.2165/00115677-200614010-00007

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