What incremental costs are associated with head and neck cancer (HNC), and how do they compare with the costs associated with other common cancers?
Background: HNC is the eighth most common cancer in the United States. Treatment is based on tumor site and stage and most commonly requires multidisciplinary care from ancillary providers, which can incur significant healthcare costs.
Explore this issue:October 2014
Study design: Cross-sectional analysis of a healthcare expenditure database.
Setting: An estimated 264,713 patients (annualized) with HNC identified in the Medical Expenditure Panel Surveys (MEPS) for 2006, 2008, and 2010, conducted by the Agency for Healthcare Research and Quality.
Synopsis: HNC costs were compared with lung and colon cancer, two of the most common U.S. cancers. Authors identified 264,713 ± 32,438 patients with HNC; 212.2 ± 3.3 million adult individuals without cancer, 458,903 ± 30,125 patients with lung cancer, and 565,323 ± 38,643 patients with colon cancer (annualized). HNC patients were significantly older, were more likely to be male and white, were more likely to be insured, and carried more medical comorbidities than the noncancer population. Expenditure per HNC patient was $23,407 ± $3,397, compared with $3,860 ± $52 for the noncancer population; after multivariate adjustment, patients with HNC had an expenditure of $15,852 ± $3,297 ($3,495 ± $1,045 outpatient, $6,783 ± $2,894 inpatient) per year. The unadjusted mean annual healthcare expenditure patient with per lung cancer or colon cancer patient $25,267 ± $2,375 and $16,975 ± $1,291, respectively. Study limitations included the inability to stratify healthcare cost by cancer stage and the inability of MEPS to provide statistically reliable estimates for some of the subcost analyses of the expenditures within HNC patients.
Bottom line: Despite its lower relative incidence, HNC is associated with a significant incremental increase in annual healthcare expenditures per individual (aggregate $4.2 billion), which is comparable with or higher than lung and colon cancer costs.
Citation: Dwojak SM, Bhattacharyya N. Incremental and comparative healthcare expenditures for head and neck cancer in the United States. Laryngoscope. 2014;124: 2305-2308.
—Reviewed by Amy Eckner