Determinants of Medicare Costs for Elderly Patients With Oral Cavity and Pharyngeal Cancers

Hollenbeak, Christopher S.; Kulaylat, Afif N.; Mackley, Heath B.; Koch, Wayne M.; Schaefer, Eric; Goldenberg, David

doi:10.1001/jamaoto.2015.0940

Cited by 26 publications

(23 citation statements)

References 35 publications

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“…Our finding that patients’ prediagnosis co-morbidities were significantly associated with two year cost of OPC treatment is consistent with findings of previous studies (20, 21). The mean CCI of our case population was lower than that in previous studies (21, 22).…”

Section: Discussionsupporting

confidence: 93%

“…The model developed by Brisson et al (19) also applied cost-per-case data for OPC from work by Hu and Goldie (18). More recent studies have applied SEER-Medicare, state Medicaid, and commercial insurance claims data but considered oral cavity cancer (which is unrelated to HPV) and pharyngeal cancers (which include both HPV-related and non-HPV-related cancers) together (20–22). Etiology and presentation of OPC differ widely from oral cavity cancer, resulting in major differences in treatment and long-term outcomes (23–24).…”

Section: Discussionmentioning

confidence: 99%

“…This change in treatment paradigm may explain the differences in the high outpatient costs found in our study. Many prior estimates of cost pre-date or occur during this treatment transition (18, 20–21) Additionally, previous estimates may vary depending on inclusion of non-OPC cancer types and study population. Using 1995–2003 Medi-Cal data, Epstein et al (21) found a median cost of oral cavity and pharyngeal cancer of $33,358 (2015 USD) in the first year after diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Using 1995–2003 Medi-Cal data, Epstein et al (21) found a median cost of oral cavity and pharyngeal cancer of $33,358 (2015 USD) in the first year after diagnosis. Hollenbeak et al (20) used inverse probability weighting to adjust for censoring in SEER-Medicare data and found a 5-year cumulative cost of pharyngeal cancer of $48,544 (2015 USD). Hu and Goldie (18) used SEER registry and Medicare data to identify the mean cost per OPC case as $42,534 (2015 USD).…”

Section: Discussionmentioning

confidence: 99%

“…Careful selection of OPC-specific ICD-9-CM codes ensured that patients with head and neck cancers from other sites were excluded from the analysis. We included only cancer sites in the oropharynx that are known to be HPV-related, in contrast to other studies that included oral cavity sites, which may have resulted in underestimation of cost associated with treating HPV-related cancer (16, 18–20, 31). …”

Section: Discussionmentioning

confidence: 99%

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Medical Care Cost of Oropharyngeal Cancer among Texas Patients

Lairson

Chan

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background The incidence of oropharyngeal cancer (OPC) is rising rapidly, with the majority of cases being attributable to human papillomavirus (HPV). Despite the availability of a vaccine, rates of HPV vaccination among Texas youth are low. The healthcare cost of OPC in Texas is unknown. The aims of this study were to estimate the first two years cost of treating new cases of OPC and determine the predictors of OPC treatment cost in Texas. Methods This study included a retrospective cohort of 467 Texas patients with commercial insurance claims data with OPC diagnosed from 2011 to 2014 and a control group of 467 non-cancer patients obtained with propensity score matching. Total health care cost during the first two years after the index date was measured. A generalized linear model was used to identify predictors of monthly cost during the two years after the index date. Results The mean differential adjusted health care cost for OPC cases was $139,749 in the first two years. The mean adjusted monthly cost in the first two years was $6,693 for cases and $840 for controls. Age, comorbidity, mental health, pre-diagnostic health care cost, and time index were significant predictors of monthly cost. Conclusions Medical care cost was about $140,000 in the first two years after diagnosis of OPC among commercially insured patients in Texas. Impact The cost estimates provide important parameters for development of decision-analytic models to inform decision-makers about the potential value of initiatives for increasing the HPV immunization rate in the State.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Medical Care Cost of Oropharyngeal Cancer among Texas Patients

Lairson

Chan

et al. 2017

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Projected Association of Human Papillomavirus Vaccination With Oropharynx Cancer Incidence in the US, 2020-2045

2021

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Disease burden, risk factors, and trends of lip, oral cavity, pharyngeal cancers: A global analysis

Huang

Chan

et al. 2023

Cancer Medicine

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BackgroundLip, oral and pharyngeal cancers make up a small percentage of total cancer cases worldwide and have reported lower rates of cancer‐related deaths globally in 2020, but their 5‐year survival rate in either early or advanced stages is different. The study evaluated the global incidence, mortality, risk factors, and temporal trends by age, gender, and geographical locations of lip, oral cavity, and pharyngeal cancer.MethodsIncidence and mortality rates were extracted from Cancer Incidence in Five Continents (CI5) volumes I‐XI, the Nordic Cancer Registries (NORDCAN), the Surveillance, Epidemiology, and End Results (SEER) Program, and the WHO IARC mortality database. Joinpoint regression was used to calculate the Average Annual Percentage Change to examine trends.ResultsThe highest incidence rates were found in Melanesia and South‐Central Asia and mortality rates were 8.2 and 7.5. Risk factors associated with incidence and mortality included HDI, tobacco use, alcohol consumption, poor diet, and chronic health conditions such as hypertension. Increasing trends of incidence and mortality were observed in females from Malta; males aged 50 and above from the United Kingdom, and females aged 50 and above from Slovakia reporting the largest increase.ConclusionsAlthough global incidence and mortality trends reported an overall decrease, significant increases were found for older age groups and female subjects. Incidence increase may be due to the growing prevalence of lifestyle, metabolic risk factors, and HPV infections, especially in developed countries.

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Determinants of Medicare Costs for Elderly Patients With Oral Cavity and Pharyngeal Cancers

Abstract: Oral and pharyngeal cancer is burdensome to elderly patients from a Medicare cost perspective. Several factors were associated with 5-year costs, including some modifiable factors that may be potential targets for interventions to reduce overall costs.

Cited by 26 publications

References 35 publications

Medical Care Cost of Oropharyngeal Cancer among Texas Patients

Medical Care Cost of Oropharyngeal Cancer among Texas Patients

Projected Association of Human Papillomavirus Vaccination With Oropharynx Cancer Incidence in the US, 2020-2045

Disease burden, risk factors, and trends of lip, oral cavity, pharyngeal cancers: A global analysis

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