Metastatic non-small cell lung cancer: Costs associated with disease progression

Objective: To compare direct costs of care among patients having advanced non-small cell lung cancer (NSCLC) with versus without disease progression following first-line chemotherapy. Study Design: A retrospective study was conducted among patients with stage IIIB or IV metastatic NSCLC diagnosed between January 1, 2001, and May 30, 2005. Methods: Progression was defined as a change in chemotherapy regimen and radiologic confirmation of tumor growth. Total direct costs after diagnosis were computed monthly and were aligned chronologically between patients with and without progression to determine the mean costs for the 3 months after progression. Multivariate linear regression analysis estimated predictors of progression costs. Results: Among 306 patients with NSCLC who received chemotherapy, 108 patients experienced documented progression. Total cost of care from progression to death or end of study was $42,066. The mean direct 3-month postprogression cost of care was $31,129 for patients with progression compared with $18,802 for patients with stable disease, yielding an incremental cost of $12,327. Conclusion: Patients with metastatic NSCLC who experience progression have significantly greater costs than similar patients with stable disease.