The use of early palliative care for patients with metastatic non-small cell lung cancer (NSCLC) may not increase health care costs over the trajectory of the disease or in the last 30 days of life, a study reported at the 2014 Palliative Care in Oncology Symposium in Boston, Massachusetts (Abstract #4).

Researchers at Massachusetts General Hospital Cancer Center in Boston, Massachusetts, conducted a secondary analysis to investigate whether early palliative care integrated with standard care versus standard care alone was more or less costly in patients with newly diagnosed metastatic NSCLC.

Costs obtained from the hospital’s accounting system to account for total costs per day included emergency and inpatient care, clinic visits, intravenous chemotherapy, and physician services. Oral chemotherapy costs and hospice costs were estimated for the analysis, which Joseph Greer, BA, of Massachusetts General Hospital, said was difficult to do, while presenting the results of the study.

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Researchers calculated the average total cost of care per day for both the entire study and for the last 30 days before death for each participant.

Results showed that early palliative care was associated with a $117 lower total cost per day compared with standard care (P=0.09); however, in the final 30 days prior to death, patients who received early palliative care had an average $1,053 higher total cost for hospice care (P=0.11). Chemotherapy costs were $757 lower for the early palliative care group during the same period

“Although this secondary analysis did lack statistical power, it does seem to be clear that the use of this model is not increasing health care costs per se, and there may be some indicators in a larger study that [early palliative care] could actually save costs on average per day,” Greer said.