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Trends in Drug Costs and Overall Survival in Patients with Metastatic Non-small Cell Lung Cancer in The Netherlands Diagnosed from 2008 Through 2014


  • Christine M. Cramer-van der Welle

    (Santeon Hospital Group)

  • Bas J. M. Peters

    (St. Antonius Hospital)

  • Maarten J. Deenen

    (Catharina Hospital)

  • Franz M. N. H. Schramel

    (St Antonius Hospital)

  • Ewoudt M. W. Garde

    (St. Antonius Hospital
    Utrecht University)


Background The Value-Based Health Care concept defines patient value as patient-relevant outcomes divided by costs. The aim of the present study was to assess the development of systemic treatment costs over the years compared with changes in overall survival (OS) at the level of a diagnosis of stage IV non-small cell lung cancer (NSCLC). Methods All patients diagnosed (in 2008–2014) with stage IV NSCLC and treated with systemic treatment in six Dutch large teaching hospitals (Santeon network) were included. We collected data on OS and amounts of drug units (milligrams) for every drug in the applied systemic cancer treatments, until death. These amounts were multiplied by Dutch unit costs (Euros/mg) expressed in 2018 Euros to construct total drug costs per line of treatment per patient. Costs for day care visits were added for drugs requiring parenteral administration. Results Data were collected from 1214 patients. Median OS and mean total drug costs showed no significant variation over the years (p = 0.437 and p = 0.693, respectively). Mean total drug costs per 1 year of survival ranged from €20,665 to €26,438 during the period under study. Costs for first-line systemic treatment were significantly higher in 2011–2014 compared with 2008–2010. Conclusion This study shows that overall drug costs were stable over the years, despite a relative increase in first-line treatment costs. Median OS remained at around 8 months from year to year. These trend data are very relevant as background for the assessment of costs and achieved outcomes in the more recent years.

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  • Christine M. Cramer-van der Welle & Bas J. M. Peters & Maarten J. Deenen & Franz M. N. H. Schramel & Ewoudt M. W. Garde, 2021. "Trends in Drug Costs and Overall Survival in Patients with Metastatic Non-small Cell Lung Cancer in The Netherlands Diagnosed from 2008 Through 2014," PharmacoEconomics - Open, Springer, vol. 5(1), pages 121-127, March.
  • Handle: RePEc:spr:pharmo:v:5:y:2021:i:1:d:10.1007_s41669-020-00220-z
    DOI: 10.1007/s41669-020-00220-z

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    References listed on IDEAS

    1. Tim A Kanters & Clazien A M Bouwmans & Naomi van der Linden & Siok Swan Tan & Leona Hakkaart-van Roijen, 2017. "Update of the Dutch manual for costing studies in health care," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-11, November.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Journal round-up: PharmacoEconomics – Open 5(1)
      by Rita Faria in The Academic Health Economists' Blog on 2021-04-29 06:00:05

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