Despite growing evidence that patients with advanced non-small-cell lung ca
ncer have improved survival and better symptom control with modern systemic
therapy, there is still resistance to the use of chemotherapy because of t
he perceived modest magnitude of benefit and concern about its cost. An ana
lysis of the economic burden of care for non-small-cea lung cancer irt Cana
da has revealed that the average cost to provide this care over 5 years is
approximately $30,400 (1993 Canadian dollars). A large component of this co
st, however; is related to initial diagnosis and in-hospital care, and to t
erminal care costs. Estimates of most of the commonly used chemotherapy reg
imens demonstrate that they are cost-effective and amount to less than the
$20,000 per quality-adjusted life-year gained that is thought to be accepta
ble for the early adoption of a health-care intervention in Canada. Some ch
emotherapy regimens actually have the potential to decrease total health-ca
re costs by reducing the use of acute care hospital beds for terminal care.
Combined modality therapy for locally advanced iron-small-cell lung cancer
has also been shown to be cost-effective.:The available evidence is that t
he cost of treating advanced non-small-cell lung cancer is not excessive, a
nd estimates of cost-effectiveness are well within the commonly accepted ra
nge for the adoption of a new health-care technology.