OBJECTIVES: Head and neck cancer (HNC) is the sixth most common neoplasm in the U.S.; approximately $3.2 billion are spent annually for treatment. The projected average Medicare payment per individual in the first year following diagnosis is $18,000 in year 2007. However, limited information is available regarding cost expenditure in commercial managed care plans. The purpose of this study was to report the first year per patient cost expenditure after HNC diagnosis among commercially insured lives. METHODS: A cross-sectional study was performed using data from a large U.S. commercial managed care claims database. Adult patients (≥18 years) diagnosed with HNC (based on ICD-9-CM codes) between January 1, 2006 to December 31, 2006 (index-period) without previous HNC diagnosis 12 months prior to index date (first date of HNC diagnosis) were identified. At 12 months post index, total healthcare costs were extracted from medical claims and summarized at per patient level. RESULTS: 6,570 subjects were identified. The average age was 61 years (±14.9) and 44% (n=2869) were females. Midwest (31%) and east (31%) regions had a higher (p<.01) representation, compared to south (20%) and west (18%). The 5 most common HNC sites constituted 70% of total diagnosis and consisted of unspecified HNC sites (24%; n=1588), lymph nodes (15%; n=1010), larynx (14%; n=898), connective and soft tissues (9%; n=579), and tongue (9%; n=507). Commonly utilized service types were physician (99%; n=6,486), other outpatient ancillary/surgical (99%; n=6,474) and laboratory/diagnostic (90%; n=5,888). Subjects had frequent visits to general practitioners (53%; n=3,509), internal medicine doctors (38%; n=2,523), and otolaryngologists (35%; n=2,291). Total average and median healthcare cost per patient post HCN diagnosis were $29,608 (±77,500) and $7,347, respectively. CONCLUSIONS: This study found that the annual cost associated with HNC is higher in the commercial managed care population compared with what has been reported in the literature for Medicare expenditure.