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
. 2019 Jul 22:11:441-451.
doi: 10.2147/CEOR.S198312. eCollection 2019.

Clinical and economic burden of head and neck cancer: a nationwide retrospective cohort study from France

Antoine Schernberg  1 , Luis Sagaon-Teyssier  2   3 , Michaël Schwarzinger  3   4 ; EPICORL Study Group
Affiliations

Clinical and economic burden of head and neck cancer: a nationwide retrospective cohort study from France

Antoine Schernberg et al. Clinicoecon Outcomes Res. .

Abstract

Objectives: To evaluate the clinical and economic burden of head and neck squamous cell carcinoma (HNSCC) in France.

Methods: All 53,255 incident adult patients discharged with a first diagnosis of HNSCC in 2010-2012 were identified from the 2008-2013 French National Hospital Discharge (PMSI) database. We conducted a retrospective longitudinal analysis of prognosis and direct costs attributable to HNSCC.

Results: Direct medical costs attributable to HNSCC care amounted to 665 million euros in 2012 in France. The majority (62%) of incident patients were 64 years old or less at HNSCC diagnosis and incurred 1.3-fold higher mean direct costs as compared to elderly patients (41,909 vs 32,221 euros over 3 years, respectively; p<0.001). HNSCC stage at initial treatment was the major driver of mean (SD) direct costs over 3 years (p<0.001): 19,819 (23,150) euros in 31% patients diagnosed at early stage; 46,791 (34,841) euros in 60% patients diagnosed at locally advanced stage; and 43,377 (33,953) euros in 9% patients diagnosed with distant metastasis. About half patients died over 3 years at a median (IQR) age of 63 (56-75) years resulting in 10.9 years-of-life lost on average per incident patient.

Conclusion: The present study suggests that the clinical and economic burden of HNSCC is substantial in France.

Keywords: National Hospital discharge database; burden of disease; costs; head and neck squamous cell carcinoma; prognosis.

PubMed Disclaimer

Conflict of interest statement

All authors have completed the ICMJE Competing Interest form and declare that: LST was an employee of Translational Health Economics Network (THEN), Paris, France; MS is the founder/CEO of Translational Health Economics Network (THEN), Paris, France that received research grants from MSD France as well as Abbvie, Gilead and Novartis, outside and unrelated to the submitted work. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Prevalent direct costs attributable to head and neck squamous cell carcinoma (HNSCC) care in 2012 in France (in million €)
Figure 2
Figure 2
Mean monthly costs of head and neck squamous cell carcinoma (HNSCC), by phase-of-care and main cost category. Notes: Direct costs include reimbursements to public/private hospitals in acute and post-acute care, out-of-pocket expenses for inpatient stays, radiation therapy imputed in the private sector, and medical transportation to/from hospital.
See this image and copyright information in PMC

References

    1. GBD. 2015 Disease and injury incidence and prevalence collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global burden of disease study 2015. Lancet. 2016;388(10053):1545–1602. doi:10.1016/S0140-6736(16)31678-6 - DOI - PMC - PubMed
    1. Global Burden of Disease Study 2015. Global Burden of Disease Study 2015 (GBD 2015) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME); 2016. Available from: http://ghdx.healthdata.org/gbd-results-tool.
    1. Gatta G, Botta L, Sanchez MJ, et al. Prognoses and improvement for head and neck cancers diagnosed in Europe in early 2000s: the EUROCARE-5 population-based study. Eur J Cancer. 2015;51:2130–2143. doi:10.1016/j.ejca.2015.07.043 - DOI - PubMed
    1. Seiwert TY, Burtness B, Mehra R, et al. Safety and clinical activity of pembrolizumab for treatment of recurrent or metastatic squamous cell carcinoma of the head and neck (KEYNOTE-012): an open-label, multicentre, phase 1b trial. Lancet Oncol. 2016;17(7):956–965. doi:10.1016/S1470-2045(16)30066-3 - DOI - PubMed
    1. Ferris RL, Blumenschein G Jr., Fayette J, et al. Nivolumab for recurrent squamous-cell carcinoma of the head and neck. N Engl J Med. 2016;375(19):1856–1867. doi:10.1056/NEJMoa1602252 - DOI - PMC - PubMed

LinkOut - more resources