OBJECTIVES: Chemotherapy (CT)-induced Adverse Events (AEs) are frequent in patients with Head and Neck (HN) cancer. Understanding of cost of AEs management is needed for economic evaluation of drugs. Our objective was to assess resource use and costs associated with CT-induced AEs in patients with HN cancer according to societal perspective.

METHODS: This retrospective analysis used a nationwide representative sample (1/97th) of the French insurance claims database (Echantillon Général des Bénéficiaire; EGB). Over a 6-year period (2009–2014), patients with a diagnosis of recurrent or metastatic HN cancer (ICD10 codes: C00-06; C09-14; C32), and treated exclusively with chemotherapy were selected. The eight most frequent chemotherapy-induced AEs were identified through healthcare consumption: rash (emollient cream, anti-histaminic, dermocorticoïds), anemia (iron, ESA, transfusion), alopecia (wig), infection (antibiotics), diarrhea (anti-diarrheal), stomatitis (anti-fungal), nausea/vomiting (antiemetic), and neutropenia (G-CSF). Each AE management cost was assessed based on healthcare consumption.

RESULTS: Of 444 patients with recurrent or metastatic HN cancer treated with chemotherapy, 378 patients (85%) had on average 2.9 AEs. The mean costs of AEs were (from most to least expensive): €2812 [95%CI:2153–3472], €2237 [1787–2687], €285 [244–326], €184 [143–225], €125 [125–125], €41 [21–61], €26 [0–59], and €18 [15–21] for neutropenia (n=151, 40%), anemia (n=136, 36%), nausea/vomiting (n=281, 74%), stomatitis (n=135, 36%), alopecia (n=17, 5%), infection (n=109, 29%), diarrhea (n=92, 24%), and rash (n=191, 51%), respectively. The mean cost for anemia varied from €3471 in patients with transfusion (n=37) to €1776 in other patients (n=99).

CONCLUSIONS: An analysis of healthcare consumption related to eight types of AEs revealed that neutropenia and anemia were particularly frequent and costly. Reducing cost of chemotherapy-induced AEs by education of the patient for early detection, standardization of management care, and selection of treatments with favorable safety profile may have a substantial impact on the overall HN economic burden.