Costs and Ethical Issues Related to First-Line Treatment of Metastatic Non-Small-Cell Lung Cancer: Considerations From a Public Healthcare System Perspective

Metastatic non-small-cell lung cancer is generally not considered to be curable, and the overall 5-year survival rate is less than 1%. Despite this poor prognosis, palliative chemotherapy can increase time and quality of life in the advanced-disease setting. New chemotherapy treatments and targeted therapies are available for this stage of disease, but their high costs are an important issue. In this perspective article, we discuss the hospital costs of antitumor drug administration and the ethical principles involved, the roles of drug agencies and oncologists, and relevant current research on these topics. These considerations have been examined from the perspective of a national public healthcare system.