Real-World Healthcare Resource Utilization and Costs Associated with Lung Cancer in the Brazilian Private Healthcare Sector

Abstract

Objectives: Lung cancer (LC) is the leading cause of cancer-related mortality worldwide and the fourth most incident cancer in Brazil. LC is frequently diagnosed at advanced stages and is associated with high direct healthcare costs. This study aimed to evaluate epidemiological data and the costs associated with LC in the Brazilian private healthcare market.

Methods: A retrospective study was conducted including patients diagnosed with LC (ICD-10 code C34) between January 2019 and December 2024, identified in a national health insurance claims database comprising 60,824 beneficiaries. The primary outcome focused on the analysis of the median utilization of cancer-related healthcare resources and direct costs per patient per year after diagnosis, until discontinuation of chemotherapy/immunotherapy or radiotherapy due to treatment-related toxicities, disease progression, or death. Disease staging (TNM UICC 1988) at diagnosis and treatment initiation was evaluated. Kaplan–Meier curves were used to estimate cumulative survival rates. Chi-square, Fisher’s exact, and Student’s t-tests were applied for categorical and continuous variables, respectively. Statistical significance was defined as p < 0.05.

Results: In our analysis, the age-standardized prevalence rate of LC was 260 cases per 100,000 inhabitants (mean age 72 years; 53% female). Annual procedure rates included 8.9 consultations, 2.5 emergency department visits, 115.2 diagnostic tests, and 1.5 hospitalizations per patient. The mean hospital length of stay was 10.1 days. Annual healthcare costs were US$52,029 per patient. Among reimbursed medications, 60.1% were anti–PD-1/PD-L1 monoclonal antibodies, 9.3% anti–VEGF/VEGFR monoclonal antibodies, 6.3% EGFR tyrosine kinase inhibitors, 3.9% antineoplastic antimetabolite agents, 1.7% anti-EGFR monoclonal antibodies, and others (18.7%). The cumulative 5-year survival rate was 20.1%.

Conclusions: This study highlights the high prevalence of LC, with significant epidemiological impact, frequent diagnosis at advanced stages, and low survival in the Brazilian private healthcare system. The intensive use of healthcare resources generates substantial costs, particularly related to molecular targeted therapies and immunotherapies, which, despite their high costs, demonstrate significantly better outcomes than chemotherapy. Addressing this dual challenge requires improvements in screening, personalized treatment strategies, and cost-effective resource allocation to reduce the economic burden and improve clinical outcomes.