Incremental and comparative health care expenditures for head and neck cancer in the United States

Objectives/Hypothesis Determine the incremental costs associated with head and neck cancer (HNCa) and compare the costs with other common cancers. Study Design Cross‐sectional analysis of a healthcare expenditure database. Methods The Medical Expenditure Panel Survey is a national survey of US households. All cases of HNCa were extracted for 2006, 2008, and 2010. The incremental expenditures associated with HNCa were determined by comparing the healthcare expenditures of individuals with HNCa to the population without cancer, controlling for age, sex, education, insurance status, marital status, geographic region, and comorbidities. Healthcare expenditures for HNCa were then compared to individuals with lung cancer and colon cancer to determine relative healthcare expenditures. Results An estimated 264,713 patients (annualized) with HNCa were identified. The mean annual healthcare expenditures per individual for HNCa were $23,408 ± $3,397 versus $3,860 ± $52 for those without cancer. The mean adjusted incremental cost associated with HNCa was $15,852 ± $3,297 per individual ( P  < .001). Within this incremental cost, there was an increased incremental outpatient services cost of $3,495 ± $1,044 ( P  = .001) and an increased incremental hospital inpatient cost of $6,783 ± $2,894 ( P  = .020) associated with HNCa. The annual healthcare expenditures per individual fell in between those for lung cancer ($25,267 ± $2,375, P  = .607) and colon cancer ($16,975 ± $1,291, P  = .055). Conclusions Despite its lower relative incidence, HNCa is associated with a significant incremental increase in annual healthcare expenditures per individual, which is comparable to or higher than other common cancers. In aggregate, the estimated annual costs associated with HNCa are $4.20 billion. Level of Evidence 2b. Laryngoscope 124:2305–2308, 2014