Cost Considerations in the Treatment of Oropharyngeal Squamous Cell Carcinoma

Abstract

An algorithm of transoral surgical treatment of OP SCCA with adjuvant treatment as indicated by pathology is more cost conscious than an algorithm of treatment of all OP SCCA with CRT.

North-American survey on HPV-DNA and p16 testing for head and neck squamous cell carcinoma

“…With the advent of de-intensification clinical trial results showing similar, if not superior, overall survival rates in HPV-positive compared to HPV-negative HNSCCs [23,35,36], while having fewer and/or milder side-effects, instating an HPV testing protocol can be beneficial. Furthermore, although the majority of respondents in our survey who did not perform any HPV testing did not do so due to the high costs of the tests, a recent study by Moore et al demonstrated a significant reduction in treatment costs if de-intensification is to be undertaken in HPV-positive HNSCC patients [37]. However, for the time being, no change should be performed in the standard treatment based solely on HPV status, as there are no official guidelines and a holistic understanding of the disease has yet to be reached.…”

Analysis of Charges Associated with Definitive Nonsurgical Therapy for Early-Stage Lateralized Tonsil Cancer

“…14 Defining cost as reimbursement during a 3-month window of treatment, they concluded that upfront surgery with adjuvant treatment decided by findings on histopathology was more cost conscious. 14 However, they did not have patients treated with radiation-alone or radiation followed by surgery.…”

“…14 Defining cost as reimbursement during a 3-month window of treatment, they concluded that upfront surgery with adjuvant treatment decided by findings on histopathology was more cost conscious. 14 However, they did not have patients treated with radiation-alone or radiation followed by surgery. In addition, their surgical approaches included both transoral endoscopy with laser microsurgery and transoral robotic surgery; the latter is generally billed as an un-coded charge such that reimbursement may not reflect the cost to the institution, which would absorb potential losses.…”

“…Current surgical initiatives have included utilizing robotics; 6,14 the cost of this trend is just beginning to be explored. 14 In thyroid surgery, the cost of a robotic approach exceeds the cost of endoscopic approach.…”

“…Current surgical initiatives have included utilizing robotics; 6,14 the cost of this trend is just beginning to be explored. 14 In thyroid surgery, the cost of a robotic approach exceeds the cost of endoscopic approach. 15 A systemic review of surgical approaches in urologic surgery concluded that the cost of robotic surgery exceeded that cost of open or laparascopic approaches because of capital cost, maintenance costs, and the limited life of the instruments.…”