Aims
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 (PBS) costs.
Results
There were 4,929 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). Overall costs were predominantly driven by hospital admissions with a mean annual cost of $15,119 (SD $29,140) per person which was incurred by 70% of patients. 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 being 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).
Conclusions
Healthcare costs for patients with HNC are significant, particularly for those from rural Australia or who develop second malignancies. Future research is needed to explore ways in which healthcare delivery can be optimised to reduce cost to healthcare system and improve quality of care for patients with HNC.