title: Metastatic non-small cell lung cancer: costs associated with disease progression.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Patients with metastatic NSCLC who experience progression have significantly greater costs than similar patients with stable disease.
authors.affiliation: Strategic Healthcare Solutions, LLC, PO Box 543, Monkton, MD 21111, USA. kathyfox@comcast.net
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Fox
authors.forename: John M
authors.initials: JM
authors.lastname: Brooks
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kim
mesh_terms: D000368:Aged; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000191:economics; D002289:Carcinoma, Non-Small-Cell Lung / Q000191:economics* / Q000473:pathology* / Q000628:therapy; D003131:Combined Modality Therapy / Q000191:economics; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D018450:Disease Progression; D005260:Female; D017048:Health Care Costs / Q000145:classification / Q000706:statistics & numerical data*; D006801:Humans; D008175:Lung Neoplasms / Q000191:economics* / Q000473:pathology* / Q000628:therapy; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors