Treatment pathways, resource use and costs in the management of small celllung cancer

Background-Small cell lung cancer (SCLC) represents about 20% of primary lu ng tumours and the costs associated with the management of SCLC can be sign ificant. The main objective of this study was to obtain information on curr ent patterns of care and associated resource use and costs for patients wit h SCLC from initial diagnosis and treatment phase, throughout disease progr ession and terminal care. Methods-A 4 year retrospective patient chart analysis (1994-7) was conducte d on a consecutive series of 109 patients diagnosed with SCLC in two Newcas tle hospitals. For this consecutive series of patients all details about ca re received including tests and procedures, treatment, and medication from diagnosis till death were recorded. Pathways of care and forms were designe d to enable resource use to be captured for different disease phases. Unit costs were determined from a variety of sources including the Newcastle Hos pitals NHS Trust Finance Department and the British National Formulary. Results-The average total cost per patient calculated for the full cohort o f 109 patients was pound 11 556. Initial treatment was the most resource us e intensive constituting 48.2% of the total cost. The major cost element th roughout all disease phases was hospitalisation. Twenty eight percent of th e total costs of care occur after recurrence of the disease until death, of which 73% are generated by terminal care. Conclusion-The results of this retrospective medical chart analysis show th at the costs of care of SCLC are considerable, although the variability bet ween patients in terms of the type and quantity of resource use is very hig h. Analyses such as this provide a useful insight into resources used in ac tual clinical practice.