OBJECTIVES: To compare the health care utilization (HRU) and costs of patients with and without liver cancer in the US Medicare population.

METHODS: A retrospective data analysis was performed using 5% national Medicare data from 01JAN2011-31DEC2015. Adult patients diagnosed with liver cancer were identified using International Classification of Diseases, 9^th and 10^th Revision, Clinical Modification (ICD-9-CM; ICD-10-CM) diagnosis codes (ICD-9-CM code 155; ICD-10-CM code C22). The diagnosis date was designated as the index date. A comparison cohort of patients without a liver cancer diagnosis was created for patients of the same age, gender, race, baseline individual comorbidities, and Charlson comorbidity index score. A random index date was chosen for the comparison cohort to reduce selection bias. Patients in both cohorts were required to have continuous medical and pharmacy benefits 12 months pre- and post-index date. Propensity score matching (PSM) was performed to compare follow-up HRU and costs between the cohorts, adjusting for demographic and clinical characteristics.

RESULTS: After applying PSM, a total of 270 patients were included in each cohort (liver cancer and comparator cohorts), and baseline characteristics were balanced. A higher proportion of patients diagnosed with liver cancer had higher inpatient (40.00% vs 8.15%; p<0.0001) emergency room (ER; 32.6% vs 12.59%; p<0.0001), office (96.3% vs 77.41%; p<0.0001), outpatient (85.93% vs 53.33%, p<0.0001), and skilled nursing facility (SNF) (7.41% vs 1.11%; p=0.0003) utilization compared to patients in the comparator cohort. The liver cancer cohort also incurred significantly higher inpatient ($14,298 vs $2,279; p<0.0001), ER ($320 vs $104; p<0.0001), office ($8,585 vs $1,523; P<0.0001), outpatient ($21,039 vs $3,158; p<0.0001), SNF ($1,381 vs $193; p<0.0001), Part D pharmacy ($4,794 vs $9,549; p<0.0001), and total ($53,828 vs $9,549; p<0.0001) costs.

CONCLUSIONS: Liver cancer patients incurred higher HRU and costs than those without liver cancer.