Healthcare costs in patients with head and neck cancer

PURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.