Healthcare costs in patients with head and neck cancer

The aim of this study was to quantify the healthcare costs of patients with head and neck cancer (HNC) in Australia and investigate factors associated with increased costs.

A sub-study was performed using linked patient data from 'Lifetime Costs of Surviving Cancer - A Queensland Study (COS-Q).' Queensland residents diagnosed with a first primary mucosal head and neck squamous cell carcinoma (HNSCC) between 1997 and 2015 and who incurred costs from 2013 to 2016 were included. Healthcare costs were reported as a total mean cost per patient per year and included emergency department (ED) costs, hospital admission costs, cost for medical and allied health services and pharmaceutical costs.

There were 4929 patients with HNSCC included in the study. The total mean annual cost was $21,646 per patient with the highest costs in the first-year post treatment. Regional ($23,312) and rural ($33,627) patients experienced higher healthcare costs than those from major cities ($20,300, p < 0.001). Factors strongly associated with an increased overall healthcare cost included living in a remote location (RR 1.51, p < 0.001), having a nasopharynx (RR 1.41, p = 0.027) or hypopharynx (RR 1.60, p < 0.001) cancer or never married (RR 1.34, p < 0.001). There were 644 patients (13%) who developed a second primary malignancy and this sub-group experienced higher overall costs ($46,453 vs $24,966, p < 0.001).

Healthcare costs for patients with HNC are significant. Further research is needed to investigate ways to reduce healthcare utilisation and provide additional support in this cohort.