Treatment patterns and healthcare costs among patients with advanced non-small-cell lung cancer

Aim: To identify contemporary first-and second-line treatment patterns for advanced non-small-cell lung cancer (aNSCLC) and associated costs. Methods: This study identified aNSCLC patients through an oncology registry linked to a large US commercial claims database. Patients with aNSCLC (stage IIIb or IV) and continuous enrollment in the health plan from diagnosis until death were included. First and second lines of therapy and their associated costs were determined. Results: The most common first-line regimens (n = 335) were platinum-taxane doublets alone (29%) or in combination with bevacizumab (14%) or pemetrexed (6%). Most second-line regimens (n = 74) contained pemetrexed, bevacizumab and/or erlotinib. Mean total healthcare costs ranged from US$19,182 to US$167,847 (first-line) and from US$35,737 to US$135,364 (second-line). Systemic therapy represented 20-55% of first-line and 22-68% of second-line total costs. Conclusion: Pemetrexed and targeted therapies are prevalent in both first-and second-line regimens. Total and systemic therapy-related costs exhibited considerable variability by regimen.