Medicare Costs on the Rise for Older Oral Cancer Patients

Costs grow for people with oral cavity and pharyngeal cancers based on demographics, co-existing illnesses, and treatment selection.

The cost of treating oral cancer increased for older oral cancer patients on Medicare, according to the results of a recent study.

Published online recently in JAMA Otolaryngology-Head & Neck Surgery, researchers found growing Medicare costs from 1995-2005 for older patients receiving treatment for oral cavity and pharyngeal cancers based on demographics, comorbidities, and therapy selection. The study noted that many oral cavity cancer patients and the majority of pharyngeal cancer patients are diagnosed at advanced stages when disease management is complex with aggressive treatment from multiple specialists.

The researchers examined data from Medicare and Surveillance, Epidemiology and End Results hospitals for 6724 oral cavity cancer patients and 3987 pharyngeal cancer patients all aged 66 years and over. The researchers then measured the 5-year cumulative costs following the initial diagnosis, defined as Medicare Part A and B payments.

The results show that on average, African-American oral cavity cancer patients paid $11,450 more in costs than Caucasian patients, while African-American pharyngeal cancer patients paid $25,093 more than Caucasian patients. Comorbid conditions were found to have a significant effect on the average 5-year cumulative costs.

Furthermore, the data showed that 1 or 2 co-existing illnesses caused the average cumulative cost to jump by $13,342 for oral cavity cancer patients and $14,139 for pharyngeal cancer patients. Meanwhile, having 3 or more co-existing illnesses grew costs by $22,196 for oral cavity cancer patients and $27,799 for pharyngeal cancer patients.

The choice of treatment was also found to be a significant cause of cumulative costs. Patients on chemotherapy paid an average of $26,919 more by 5 years for oral cavity cancer and $37,407 more for pharyngeal cancer.

The researchers noted that the findings cannot be generalized to younger patients because the study utilized Medicare data. Outpatient drug costs were also not included because Medicare did not reimburse for drugs during the study period.

"With an attributable cost of $27,000 for patients with oral cavity cancer and $40,000 for pharyngeal cancers, there are substantial costs attributable to this disease,” the authors wrote. “Although any comprehensive effort to reduce the economic burden of oral cavity and pharyngeal cancers must emphasize preventive and early diagnostic measures given the role of comorbidities and treatment modality as the primary determinants of cumulative costs at five years, further research will be needed to understand the cost-effectiveness of different modalities of treatment in patients with varying levels of comorbidities and stage of disease."