170P Change in the epidemiology and costs of metastatic lung cancer in France between 2013 and 2021: Observational study using the SNDS

Treatment landscape in metastatic lung cancer is quickly evolving and is associated with improved survival but also increased costs. However, epidemiological data on the survival and costs of patients at metastatic stage are limited. This study aimed to describe change in epidemiological data and costs of these patients between 2013 and 2021. From the French national claims database (SNDS), a dynamic cohort of patients identified between 2013 and 2021 with metastatic lung cancer and a marker for the presence of metastases (ICD-10 code or at least one reimbursement for Bevacizumab or Pemetrexed) was constituted. A patient was considered as newly diagnosed if no other marker of the presence of metastases were identified in the 7 years prior to inclusion in the cohort. A trend analysis of the rate of newly diagnosed metastatic patients, the proportion of deaths and the mean monthly cost per patient over the period 2013-2021 was performed using Joinpoint software. 147,760 metastatic lung cancer patients were identified between 2013 and 2021: 66.5% of men, with a median age of 66 years. Between 2013 and 2021, a statistically significant decrease in the crude rate of newly diagnosed metastatic patients was highlighted in men (-1.18% per year in average), whereas a statistically significant increase was described in women (+2.36% per year in average). A statistically significant decrease in the proportion of deaths was described for both men and women (-4.37% and -5.07% per year on average, respectively). The mean monthly cost per patient decreased from 2013 to 2015 (from 5,685€ to 4,790€), by 8.90% per year (95%CI: -15.67 to -1.59), then stabilized (1.35%; 95%CI: -0.12 to 2.84). This study provides unpublished epidemiological data on metastatic lung cancer in France and confirms differentiated trends in the number of newly diagnosed metastatic patients in men and women, already observed for all stages combined. A statistically significant decrease in the proportion of deaths among metastatic lung cancer patients is observed in both gender over the study period. The mean monthly cost per patient initially decreased, then stabilized between 2015 and 2021.