Analysis of Medical and Pharmaceutical Expenses for Lung Cancer Before and After the Introduction of Immunotherapy

Lung cancer has been the leading cause of cancer-related deaths in Korea and is considered one of the world’s most costly cancer to treat. Novel insights into the molecular biology of lung cancer discovered in recent years have facilitated the use of targeted therapy and immunotherapy, arousing concerns over the financial burden of patients due to high healthcare costs. Using HIRA-NPS (Health Insurance Review & Assessment Service-National Patient Sample) database from 2015 to 2020, we analyzed lung cancer patients’ both medical and pharmaceutical expenditures. This study focused on targeted therapies and immunotherapies and compared these expenditures before and after the introduction of immunotherapy. In our analysis, the number of patients prescribed targeted drugs and immunotherapies for lung cancer continues to increase yearly, and consequentially pharmaceutical expenses are also on the rise. An interrupted time series analysis showed pharmaceutical expenditures for lung cancer increased immediately after the introduction of immunotherapy and have continued to increase since then, while total medical expenses, medical and pharmaceutical expenses per patient have not shown any further increase after the immediate increase. The number of patients in immunotherapy has increased but there is little change in drug prices, such as drug price cuts or the entry of more expensive drugs, so the spending per patient has not consistently increased.