End-of-LIFE Cost for Lung Cancer Patients in Greece: A hospital-based retrospective study

14 July 2021
Kourlaba G, Kokkotou E, Papaspiliou A, Stefanou G, Stournara L, Syrigos K. Value in Health. 2019;22:S476. https://doi.org/10.1016/j.jval.2019.09.405

Objectives: Estimating the management cost across phases of cancer care, and how it varies according to patient characteristics, is critical for both improving patient care and guiding health care policy. The aim of the present study was to estimate the cost of patients with lung cancer at their end-of-life (EOL) phase of care in Greece.

Methods: A hospital-based retrospective study was conducted in the Oncology Unit of “Sotiria” Hospital, in Athens, Greece. All lung cancer patients who died between 1/1/2015 and 21/12/2018 with at least 6 months follow-up were enrolled in the study. Healthcare resource utilization data, including inpatient and outpatient ones, during the last 6 months before death was extracted from a registry kept in the Unit. This data was combined with the corresponding local unit costs to calculate the 6-month, 3-month and 1-month EOL cost in €2019 values.

Results: A total of 122 patients met the inclusion criteria. The mean (standard deviation) age at diagnosis was 67.8 (8.9) years with 78.7% of patients being male and 55.0% diagnosed at stage IV. 81.1% of patients had been diagnosed with non-small-cell-lung-cancer (NSCLC) and 18.9% with small-cell-lung-cancer (SCLC). The median overall survival of these patients was 10.8 months. During the EOL periods, the mean cost/patient in the last 6 months, 3 months, and 1 month were €7,855, €3,540, and €1,198, respectively. Pharmaceutical cost was the key driver of the total cost (75% of the total 6-month) followed by radiation therapy (15.8%). The median EOL 6-month cost was marginally statistically significantly higher among patients with NSCLC (€8,408) compared to SCLC (€5,474), while no significant difference was detected at 3- and 1-month costs.

Conclusions: The findings of the present study indicate that lung cancer treatment incurs high costs in Greece, mainly attributed to pharmaceutical expenses, even at the EOL phase.