Impact médico-économique du bilan et du traitement des cancers bronchiques

The purpose of this article is to review the economics of lung cancer treatments. After a brief overview of the economic burden of lung cancer, we review the cost-effectiveness of diagnostics patterns and treatments for the different stages of lung cancer. In patients with localized disease, adjuvant chemotherapy appears to have high costeffectiveness, even if there are few published data. In regional disease, combined modalities (chemotherapy, surgery and/or radiotherapy) are probably cost-effective but we lack high-quality economic analyses. In advanced NSCLC, third-generation chemotherapies used in the first-line setting can be administered with acceptable, incremental cost-effectiveness. In the second-line setting, new agents (docetaxel, pemetrexed and erlotinib) have reasonable cost-effectiveness. The lack of cost-utility analyses for elderly patients and patients with a poor prognosis rules out firm conclusions. This review suggests that most therapies for NSCLC are cost-effective when the patient has good performance status.