The health and economic burden of lung cancer in Australia: A dynamic model of quality of life and productivity loss.

[BACKGROUND] Prior studies estimated lung cancer costs; none examined quality of life and work productivity in Australia via population-based models.

[OBJECTIVE] Quantify lung cancer's burden in working-age Australians using a dynamic Markov lifetable, estimating quality-adjusted life years (QALYs) and productivity-adjusted life years (PALYs) lost.

[METHODS] We developed a dynamic comparative Markov lifetable model to simulate both incident and prevalent cases of lung cancer among Australians aged 20-64 years from 2022 to 2031. Two parallel scenarios were modelled: (i) a base-case scenario reflecting individuals diagnosed in 2022 (incident model) and those living with lung cancer from 2012 to 2021 (prevalent model), and (ii) a counterfactual scenario in which no individuals had lung cancer. The differences between these simulations were used to estimate life years, QALYs, and PALYs lost. Model inputs were derived from previously published data. The economic value of productivity losses was estimated using the 2022 Australian gross domestic product (GDP) per full-time equivalent worker, applying a 5 % annual discount rate.

[RESULTS] Over the twenty-year period, lung cancer is projected to result in the loss of 28,430 life years, 55,964 QALYs, and 60,310 PALYs, equating to AU$14.45 billion in lost GDP. Sensitivity analyses confirmed the robustness of the model to variations in key parameters.

[CONCLUSION] Lung cancer imposes a substantial health and economic burden among working-age Australians. By combining QALY and PALY metrics within a dynamic modelling framework, this study provides a comprehensive assessment of the burden faced by this population and may inform future research and economic evaluations.