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HPV vaccination crucial to lower oropharyngeal cancer rates, costs
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Amid rising cases of oropharyngeal cancer, which are mostly attributable to human papillomavirus, medical care costs for commercially insured patients in Texas were nearly $140,000 — nearly 10 times those of healthy people, according to recently published data.
“The mean adjusted difference in health care costs between cases and controls provides the primary estimate of the mean cost of treating a patient with oropharyngeal cancer in Texas,” David R. Lairson, PhD, from the School of Public Health, University of Texas Health Science Center at Houston, said in a press release. “This provides an estimate of the potential savings per case that can be avoided by HPV immunization, which is highly relevant to HPV immunization policy assessment.”
Lairson and colleagues noted there were 11,000 new cases of oropharyngeal cancer attributed to HPV annually from 2008 to 2012 and that the CDC reported that oropharyngeal cancer is the most common HPV-related cancer.
“The HPV vaccine is highly effective at preventing oncogenic infections and HPV-related premalignancies,” Lairson and colleagues wrote. “However, the immunization rate in Texas is low where there is no school-based HPV vaccine requirement.”
The researchers sought to estimate the cost of treatment for new oropharyngeal cancer patients during the first two years. They retrospectively reviewed data from 467 patients with oropharyngeal cancer and 467 healthy controls.
Health care insurance plans were not significantly different between groups.
Compared with controls, patients had significantly higher total health care expenditures during the first 2 years after diagnosis ($134,454 vs. $13,693; P < .001), out-of-pocket payments ($2,825 vs. $1,192; P < .001), outpatient service payments ($106,604 vs. $5,738; P < .001) and inpatient service payments ($24,341 vs. $5,031; P < .001).
Adjusted total health care costs remained significantly higher among patients with oropharyngeal cancer compared with controls ($160,639 vs. $20,890; P < .001) for a difference of $139,749 in the first 2 years after diagnosis.
“Of note, we did not estimate lost productivity due to oropharyngeal cancer, which is a cost in addition to medical care,” Lairson said in the release.
Patients with oropharyngeal cancer had a mean adjusted monthly cost during the first 2 years of $6,693, compared with $870 for controls. According to the researchers, the significant predictors of monthly cost over the first 2 years included age, Charlton comorbidity index, psychiatric diagnosis groups, prediagnosis health care cost, case vs. control status, polynomial of fifth degree of months since index date and the interaction term of 24-month index between case and control.
“There is currently no screening paradigm for oropharyngeal cancer, and with few symptoms in early stages, the disease often presents at an advanced stage. The latency of HPV-induced oropharyngeal cancer is long and is often diagnosed in the fifth or sixth decade of life,” Lairson and colleagues wrote. “Given these characteristics, immunization against HPV is an effective strategy to reduce the morbidity and economic cost of oropharyngeal cancer.” – by Talitha Bennett
Disclosure: The researchers report no relevant financial disclosures.
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Lairson DR, et al. Cancer Epidemiol Biomarkers Prev. 2017;doi:10.1158/1055-9965.EPI-17-0220.
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