Predictors of Costs for Treating Two Cancer Types in Older Adult Patients

Despite the fact that over 8,400 patients die per year from oral cavity and pharynx cancers—most of whom are over the age of 65—the costs associated with these illnesses are not well understood. Thus, a group of researchers from The Pennsylvania State University (Hershey, PA) and the Johns Hopkins Head and Neck Cancer Center (Baltimore, Maryland) evaluated data from Medicare and Surveillance, Epidemiology, and End Result hospitals between January 1, 1995 and December 31, 2005, to identify the primary determinants of costs associated with treating oral cavity cancer and pharyngeal cancer.

Total costs for the 5-year period were estimated from Medicare Parts A and B payments using inverse probability weighting. Linear regression models were used to analyze and estimate the effects of various covariates on cumulative costs.

Of the variables studied, the three most influential were found to be demographics, comorbidities, and treatment selection. The costs associated with treating African-American patients with oral cavity cancer and pharyngeal cancer were $11,450 and $25,093 higher, respectively, than those associated with treating white patients. The presence of one or two comorbidities increased 5-year cumulative costs by $13,342 and $14,139. 30, and the presence of more than two comorbidities resulted in cumulative cost increases of $22,196 and $27,799, for treating oral cavity cancer and pharyngeal cancer, respectively. Strikingly, patients who received chemotherapy treatment for oral cavity cancer and pharyngeal cancer had mean costs $26,919 and $37,407 higher, respectively, than patients who received other types of treatment.

The authors noted that the study relied only on administrative data and that, because Medicare statistics were used, the study could not include younger patients. Additionally, because Medicare did not provide reimbursements for drugs during the time period when the study took place, the cost of these drugs could not be included in the analyses (https://bit.ly/1IHfdNS).

Despite these limitations, the study demonstrates that the costs associated with treating oral cavity and pharyngeal cancers are highly burdensome to older adult patients. However, the researchers concluded that any efforts to alleviate the substantial costs associated with treating these diseases must be weighed against the need to provide quality care. — Sean McGuire