Unmet Need in Non-Metastatic Oral Cavity Cancer in the United States: A Targeted Literature Review
Author(s)
Toluwase Akinsoji, MSc1, Nick Dragojlovic, PhD1, Michael Valic, PhD2, Jonathan C. Irish, MD2, Gang Zheng, PhD2, Mark Harrison, PhD1, Larry D. Lynd, PhD1;
1University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada, 2Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
1University of British Columbia, Faculty of Pharmaceutical Sciences, Vancouver, BC, Canada, 2Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
Presentation Documents
OBJECTIVES: Unmet clinical need is a key driver of adoption for new medical products and can be used to identify high-value use cases for emerging health technologies. This study aims to identify gaps in the current treatment of non-metastatic oral cavity cancer (OCC) in the United States (U.S.).
METHODS: We searched the OVID Medline database (September 6, 2024) with a set of key words related to OCC epidemiology, health outcomes, costs, and reimbursement trends. Studies using non-U.S. data and published before 2015 were excluded. Following title, abstract, and full text review, we iteratively developed a data extraction template based on a pilot study categorization. Full data extraction is underway.
RESULTS: Of 344 records identified in the search, 31 were included for full data extraction, of which 19 were published between 2015-2019 and 12 between 2020-2024. Study designs included retrospective cohort studies (n=18, 58%), retrospective case series (n=7, 23%), economic evaluations (n=5, 16%), and one literature review. Ten studies (32%) focused on a specific disease stage, of which 5 addressed early and advanced OCC, respectively. Seven studies (23%) specifically focused on salivary gland cancer. Preliminary results indicate that OCC incidence is higher among Medicaid enrollees, and that insurance status significantly affects treatment outcomes, with uninsured and Medicaid patients having poorer prognoses compared to those with private insurance (5 studies). Moreover, while postoperative radiotherapy improves survival in locally advanced OCC, primary radiation without surgery decreases survival in early-stage OCC (3 studies). Notably, elective neck dissection reduces costs and improves health outcomes in early OCC when compared to neck observation (2 studies).
CONCLUSIONS: Current evidence suggests that there is a significant unmet need in the treatment of OCC, providing ample opportunity for new, more effective therapeutic options. Moreover, the disparity in outcomes based on insurance status highlights the need for cost-effective therapies, which would facilitate access.
METHODS: We searched the OVID Medline database (September 6, 2024) with a set of key words related to OCC epidemiology, health outcomes, costs, and reimbursement trends. Studies using non-U.S. data and published before 2015 were excluded. Following title, abstract, and full text review, we iteratively developed a data extraction template based on a pilot study categorization. Full data extraction is underway.
RESULTS: Of 344 records identified in the search, 31 were included for full data extraction, of which 19 were published between 2015-2019 and 12 between 2020-2024. Study designs included retrospective cohort studies (n=18, 58%), retrospective case series (n=7, 23%), economic evaluations (n=5, 16%), and one literature review. Ten studies (32%) focused on a specific disease stage, of which 5 addressed early and advanced OCC, respectively. Seven studies (23%) specifically focused on salivary gland cancer. Preliminary results indicate that OCC incidence is higher among Medicaid enrollees, and that insurance status significantly affects treatment outcomes, with uninsured and Medicaid patients having poorer prognoses compared to those with private insurance (5 studies). Moreover, while postoperative radiotherapy improves survival in locally advanced OCC, primary radiation without surgery decreases survival in early-stage OCC (3 studies). Notably, elective neck dissection reduces costs and improves health outcomes in early OCC when compared to neck observation (2 studies).
CONCLUSIONS: Current evidence suggests that there is a significant unmet need in the treatment of OCC, providing ample opportunity for new, more effective therapeutic options. Moreover, the disparity in outcomes based on insurance status highlights the need for cost-effective therapies, which would facilitate access.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
HSD89
Topic
Health Service Delivery & Process of Care
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Oncology