Online Program

Trends in Military Health System Costs for Head and Neck Cancers, FY07-FY14

Monday, November 2, 2015

Michelle Kloc, Ph.D., MSN, RN, Evaluation and Measurement, Altarum Institute, Alexandria, VA
Diana Jeffery, PhD, Defense Health Agency,Clinical Support Division, Healthcare Operations Directorate, Department of Defense, Falls Church, VA
Joseph Dorris, MA, Altarum Institute, Ann Arbor, MI
Objective: This study examines the trends in costs for head and neck cancer (HNCa) patients receiving care in the Military Health System (MHS), by age group and gender from fiscal years (FY) 2007 – 2014.

Study Design: Principle ICD-9 codes for claims paid by TRICARE were obtained from the MHS Master Data Repository.  HNCa diagnoses were identified using the AHRQ Clinical Classification Software. Trend analyses were used to examine non-pharmacy and pharmacy costs. MHS beneficiaries ages 18 to 64, residing within the United States, were included only if they had accessed the healthcare system within the FY.

Principal Findings: Annual number of HNCa patients (incident and prevalence cases) was 4,195, slightly decreasing over time. Overall, non-pharmacy costs for HNCa patients decreased 6% between FY07-14; total pharmacy costs (all scripts) increased 12%. Per person non-pharmacy costs increased by over 75% for ages 18-30, by 7%-13% for ages 31-44, and slightly decreased for ages 45-64. Over the 8 years, non-pharmacy average per person costs for females were slightly higher than for males. Per person pharmacy costs increased by 20% between FY07-14; average per person costs for females was higher than for males.

Conclusions: Total costs borne by DoD to care for beneficiaries with HNCa has increased, largely because pharmacy costs and care rendered to young adults. Further research is required to identify underlying factors, such as changes in HNCa clinical guidelines and treatment options. Updates in clinical guidelines and pharmaceutical treatment options may important cost implications, which may be seen mostly clearly by age group or gender.

Learning Areas:

Biostatistics, economics

Learning Objectives:
Describe gender and age group differences in prevalence, cost and utilization for head and neck cancer patients. Describe trends in prevalence, cost and utilization for head and neck cancer patients over time. Explain pharmacy and non-pharmacy drivers of costs, including differences by age group and gender.

Keyword(s): Cancer, Health Care Costs

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been research lead or associate investigator for multiple DoD-funded projects and studies focused on analysis of TRICARE administrative claims data. A primary focus of my research is analysis of condition-specific prevalence and associated health care utilization and costs for military health system beneficiaries. I have a PhD in health policy and a clinical background to inform this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.