Relative cost difference among head and neck cancer patients with and without associated oral mucositis

We utilized healthcare claims data from the i3/Innovus Lab-Rx database from June 2003 through May 2007. Patients having head and neck cancer (H&N) as a primary diagnosis where included in the study. OM patients were required to have at least one OM diagnosis after the first observed cancer claim date. An OM diagnosis was considered to be associated with a radio- or chemotherapy treatment if the diagnosis was within 180 days of the therapy. To evaluate the Per Member Per Year (PMPY) costs, patients with at least 30 days of eligibility after the index date were included. Given the highly skewed nature of the cost distributions, nonparametric bootstrap t-tests were used.

Findings:

Of the 9,877 H&N cancer patients, one-third received radio- or chemotherapy treatment. Among those, approximately 18-25% developed OM or OM-associated conditions. The bootstrap t-tests indicated that there were statistical differences between the costs of the patients who developed OM and those who did not in all types of direct costs. The median PMPY total cost for the OM patients was $185,274 (mean = $276,241) compared to $130,436 (mean = 251,755) for the non-OM patients. Among H&N patients, sixty-six percent of the total cost was associated with outpatient visits, 23% for inpatient visits, and 4% for drug costs.

Conclusions:

The typical H&N patient with OM had higher total costs relative to those patients who did not. Effective OM prevention methods and treatments are needed as a vehicle for cost-containment to lessen the economic burden on both patients and payors.