SYSTEMATIC REVIEW OF THE DIRECT COST OF LUNG CANCER IN CHINA

To systematically review the direct cost of lung cancer in China. Systematic literature review on direct cost of lung cancer was conducted via CBMdisc, CNKI and Pubmed with retrieval time from 2010 to 2015. Inclusion and exclusion criteria were set to select appropriate researches. 12 studies were selected from 485 studies with total sample size of 63,931. The hospitalization expenses accounted for a largest proportion (81.47~85.21%) of direct cost. The average expense for the hospitalized patients ranged from ￥8,800 to ￥58,500. Among the hospitalization expenses, drug cost ranked first (41.87~66.70%) following with treatment cost (39.37%). Direct non-medical cost including nutriment, transportation and patient care accounted for 1.29 to 14.10% of the total expense. Results are not pooled together or inflated considering the wide time span. Since no national level study was available on direct cost, this study choose Shanghai as a case and estimate the first-time hospitalization expenses in 2012. It was estimated that the average cost of first-time hospitalization for each patient with lung cancer was ￥29,700 and the total expense of all patients in Shanghai was ￥0.33 billion in 2012, which was calculated based on the registered population (14,221,200) and the lung cancer incident rate (78.59/105) in Shanghai in 2012. 2015 annual estimation on national direct cost was at least 51.9 billion considering the registered population (1.37 billion), lung cancer crude incident rate (52.46/105) in 2014, estimated annual inpatient expenses(￥30,000) and estimated median OS (2 years). The direct cost of lung cancer is substantial in China, and is expected to increase significantly due to population aging and survival improvements as well as trends in treatment patterns. Large scale multi center studies should be conducted to collect more precise data to estimate and predict the economic burden.