OBJECTIVES : To assess real-world total (direct and indirect) economic costs among prevalent squamous cell carcinoma of the head and neck (SCCHN) patients in the United States (US).

METHODS : Using the Truven MarketScan Health and Productivity Management database, all privately insured and employed patients with ≥2 outpatient claims ≥30 days apart, or 1 inpatient claim, with any diagnoses of SCCHN in ≥1 calendar-year (CY) between January 1, 2013 and December 31, 2016 were selected. Patients without indirect cost data and those with other cancers in any given CY were excluded. Four cohorts were constituted, each comprising all SCCHN patients within a CY. Direct costs included inpatient care, outpatient care, prescription pharmacotherapy, and durable medical equipment; indirect costs included work absences exclusive of vacation (monetary value estimated using wage data from the US Bureau of Labor Statistics) and disability and worker compensation payments. Unadjusted estimates (2018 US dollars) were calculated per CY (approximately 94% patients were enrolled for all 12 months of each CY).

RESULTS : A total of 132, 139, 126, and 98 patients met all selection criteria in CY2013, CY2014, CY2015 and CY2016, respectively. Within each CY, the mean age was 54 years; approximately 90% were men. Adjusted mean [median] total costs were consistent, from $36,208 [$11,771] in the CY2013 cohort to $32,644 [$12,982] in the CY2016 cohort (the average for insured US adults was $5,943). Outpatient and inpatient care comprised approximately 65% and 28%, respectively, of direct costs annually; short-term disability and absenteeism comprised approximately 40% and 48%, respectively, of indirect costs annually.

CONCLUSIONS : The economic burden of SCCHN in the US is considerable and has remained consistent across recent years. Key contributors to overall burden include outpatient care and, in indirect costs, short-term disability and absenteeism. Additional research is needed to understand economic burden by stage and versus comparable healthy (non-cancer) persons.