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. 2023 Jun;45(6):1468-1475.
doi: 10.1002/hed.27359. Epub 2023 Mar 28.

Impact of monoclonal antibody therapy for head and neck cancer on end-of-life care utilization and costs

William J Benjamin  1 , Pratyusha Yalamanchi  2 , Jeremy M G Taylor  3 , Nicholas Lenze  2 , Francis P Worden  4 , Steven B Chinn  2 , Michelle M Chen  5
Affiliations

Impact of monoclonal antibody therapy for head and neck cancer on end-of-life care utilization and costs

William J Benjamin et al. Head Neck. 2023 Jun.

Abstract

Background: The impact of monoclonal antibody therapy (mAB) for advanced head and neck cancer on end-of-life health care utilization and costs has yet to be adequately studied.

Methods: Retrospective cohort study of patients aged 65 and over with a diagnosis of head and neck cancer between 2007 and 2017 within the SEER-Medicare registry assessing the impact of mAB therapy (i.e., cetuximab, nivolumab, or pembrolizumab) on end-of-life health care utilization (ED visits, inpatient admissions, ICU admissions, and hospice claims) and costs.

Results: Of 12 544 patients with HNC, 270 (2.2%) utilized mAB therapy at the end-of-life period. On multivariable analyses adjusting for demographic and clinicopathologic characteristics, there was a significant association between mAB therapy and emergency department visits (OR: 1.38, 95% CI: 1.1-1.8, p = 0.01) and healthcare costs (β: $9760, 95% CI: 5062-14 458, p < 0.01).

Conclusions: mAB use is associated with higher emergency department utilization and health care costs potentially due to infusion-related and drug toxicity expenses.

Keywords: end-of-life care; head and neck cancer; health care costs; health care utilization.

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Conflict of interest statement

Conflict of Interest Disclosure: The authors report no conflicts of interest

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