TWO-YEAR COST ANALYSIS OF COMMON HEAD AND NECK CANCERS - INDEX PROCEDURES AND ADJUVANT THERAPIES

Author(s)

Hannah C. Kwiatkowski, MPH, PhD1, Sheetal Aggarwal, -2, Scott M. Myers, MBA2, Rick Ditto, MS1;
1Axogen, Tampa, FL, USA, 2PearlDiver, Colorado Springs, CO, USA
OBJECTIVES: To examine how the cost of index surgical procedures for head and neck cancers relates to subsequent costs of adjuvant therapies over two years.
METHODS: Patients undergoing mandible reconstruction (n=2,926), neck dissection (n=27,133), parotidectomy (n=8,014), or thyroidectomy (n=45,570) were identified from a U.S. claims database. Costs were categorized as index procedure, chemotherapy, immunotherapy, radiotherapy, imaging, physical/occupational therapy (PT/OT), and speech therapy. Two-year costs were calculated and stratified by service utilization (% treated).
RESULTS: For mandible reconstruction, the two-year total cost per patient was $93,952, with the index procedure accounting for $35,835. Adjuvant therapies represented the majority of costs, including chemotherapy ($88,028/patient; 36% treated), radiotherapy ($22,836/patient; 39% treated), imaging ($5,666/patient; 86% treated), PT/OT ($22,836/patient; 28% treated), and speech therapy ($8,361/patient; 45% treated). Neck dissection patients had a similar total cost of $91,811 per patient, with $33,759 for the index procedure. Adjuvant therapies included chemotherapy ($77,533/patient; 43% treated), radiotherapy ($19,618/patient; 39% treated), imaging ($5,764/patient; 84% treated), PT/OT ($16,743/patient; 29% treated), and speech therapy ($6,874/patient; 32% treated). Parotidectomy costs averaged $68,009, with the index procedure at $8,232. Adjuvant therapies included chemotherapy ($84,242/patient; 42% treated), radiotherapy ($24,302/patient; 43% treated), imaging ($5,839/patient; 76% treated), and PT/OT ($16,408/patient; 27% treated). Thyroidectomy had the lowest average cost at $23,525, with the index procedure at $8,086. Adjuvant costs included chemotherapy ($17,248/patient; 41% treated), radiotherapy ($23,004/patient; 7% treated), imaging ($2,097/patient; 78% treated), and PT/OT ($10,198/patient; 23% treated). Across all procedures, adjuvant therapies consistently exceeded the cost of surgery, particularly chemotherapy and radiotherapy for mandible, neck, and parotid cases.
CONCLUSIONS: Adjuvant therapies account for the majority of two-year costs for head and neck cancer surgeries, often far exceeding the cost of the index procedure. Understanding these relationships is essential for evaluating the full economic impact of surgical oncology care and guiding value-based decisions.

Conference/Value in Health Info

2026-05, ISPOR 2026, Philadelphia, PA, USA

Value in Health, Volume 29, Issue S6

Code

EE374

Topic

Economic Evaluation

Topic Subcategory

Cost/Cost of Illness/Resource Use Studies

Disease

SDC: Oncology, STA: Surgery

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