Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012:4:15.
doi: 10.1186/1758-3284-4-15. Epub 2012 Apr 26.

The cost burden of oral, oral pharyngeal, and salivary gland cancers in three groups: commercial insurance, Medicare, and Medicaid

Jed J Jacobson  1 , Joel B Epstein, Frederick C Eichmiller, Teresa B Gibson, Ginger S Carls, Emily Vogtmann, Shaohung Wang, Barbara Murphy
Affiliations

The cost burden of oral, oral pharyngeal, and salivary gland cancers in three groups: commercial insurance, Medicare, and Medicaid

Jed J Jacobson et al. Head Neck Oncol. 2012.

Expression of concern in

  • Comment: Head and Neck Oncology.
    BioMed Central. BioMed Central. BMC Med. 2014 Feb 5;12:24. doi: 10.1186/1741-7015-12-24. BMC Med. 2014. PMID: 24499430 Free PMC article. Review.

Abstract

Background: Head and neck cancers are of particular interest to health care providers, their patients, and those paying for health care services, because they have a high morbidity, they are extremely expensive to treat, and of the survivors only 48% return to work. Consequently the economic burden of oral cavity, oral pharyngeal, and salivary gland cancer (OC/OP/SG) must be understood. The cost of these cancers in the U.S. has not been investigated.

Methods: A retrospective analysis of administrative claims data for 6,812 OC/OP/SG cancer patients was undertaken. Total annual health care spending for OC/OP/SG cancer patients was compared to similar patients without OC/OP/SG cancer using propensity score matching for enrollees in commercial insurance, Medicare, and Medicaid. Indirect costs, as measured by short term disability days were compared for employed patients.

Results: Total annual health care spending for OC/OP/SG patients during the year after the index diagnosis was $79,151 for the Commercial population. Health care costs were higher for OC/OP/SG cancer patients with Commercial Insurance ($71,732, n = 3,918), Medicare ($35,890, n = 2,303) and Medicaid ($44,541, n = 585) than the comparison group (all p < 0.01). Commercially-insured employees with cancer (n = 281) had 44.9 more short-term disability days than comparison employees (p < 0.01). Multimodality treatment was twice the cost of single modality therapy. Those patients receiving all three treatments (surgery, radiation, and chemotherapy) had the highest costs of cost of care, from $96,520 in the Medicare population to $153,892 in the Commercial population.

Conclusions: In the U.S., the cost of OC/OP/SG cancer is significant and may be the most costly cancer to treat in the U.S. The results of this analysis provide useful information to health care providers and decision makers in understanding the economic burden of head and neck cancer. Additionally, this cost information will greatly assist in determining the cost-effectiveness of new technologies and early detection systems. Earlier identification of cancers by patients and providers may potentially decrease health care costs, morbidity and mortality.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Total costs by payer during year after oral/pharyngeal cancer diagnosis. Notes: For sample with 1 year of follow-up. Medical and drug expenditures were adjusted to 2009 dollars using Medical Care CPI. The Cost Burden is calculated as the difference between the mean values for the OC/OP/SG cancer and matched comparison group. The p-value is from a test of statistically significant difference between the OC/OP/SG cancer and comparison group.
Figure 2
Figure 2
Employer costs by service type, for Commercial Insurance and Medicare Enrollees. Notes: For sample with 1 year of follow-up. Medical and drug expenditures were adjusted to 2009 dollars using Medical Care CPI. The Cost Burden is calculated as the difference between the mean values for the OC/OP/SG cancer and matched comparison group. The p-value is from a test of statistically significant difference between the OC/OP/SG cancer and comparison group.
Figure 3
Figure 3
Health care costs of single versus multimodal cancer treatment. Notes: For sample with 1 year of follow-up. Medical and drug expenditures were adjusted to 2009 dollars using Medical Care CPI. The p-value is from a test of statistically significant differences between OC/OP/SG cancer patients who were treated with a single modality and those treated with multiple modalities.
Figure 4
Figure 4
Trend in Total Healthcare Costs for Patients with OC/OP/SG Cancer, Commercial Coverage.
Figure 5
Figure 5
Trend in Total Healthcare Costs for Patients with OC/OP/SG Cancer, Medicare Coverage.
Figure 6
Figure 6
Trend in Total Healthcare Costs for Patients with OC/OP/SG Cancer, Medicaid Coverage.
See this image and copyright information in PMC

References

    1. Centers for Medicare and Medicaid Services, National Health Statistics Group, National Health Care Expenditures Data. January 2010.
    1. Kaiser Family Foundation and Health Research and Educational Trust. Employer Health Benefits2009 Annual Survey. September 2009.
    1. Funk GF, Hoffman HT, Hynds Karnell L, Ricks JM, Zimmerman B, Corbae DP, Hussey DH, McCulloch TM, Graham SM, Dawson CJ, Means ME, Colwill ML, Titler MG, Smith EM. Cost-identification analysis in oral cavity cancer management. Otolaryngol Head Neck Surg. 1998;118:211–220. doi: 10.1016/S0194-5998(98)80018-1. - DOI - PubMed
    1. Epstein JD, Knight TK, Epstein JB, Bride MA, Nichol MB. Cost of care for early- and late-stage oral and pharyngeal cancer in the California Medicaid population. Head Neck. 2008 Feb;30(2):178–186. doi: 10.1002/hed.20670. - DOI - PubMed
    1. Lang K, Sussman M, Friedman M, Su J, Kan HJ, Mauro D, Tafesse E, Menzin J. Incidence and costs of treatment-related complications among patients with advanced squamous cell carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 2009;135(6):582–588. doi: 10.1001/archoto.2009.46. - DOI - PubMed

Publication types