Objectives
To evaluate the healthcare resource consumption and costs in charge of the Italian National Health System (NHS) of patients with relapsing or metastatic head and neck (H&N) cancer.
Methods
From the ReS administrative database, adult patients with primary/secondary hospital diagnosis (ICD9-CM code) of H&N cancer were selected in 2015 (accrual period). At least a lymph node and/or distant metastasis diagnosis was searched in the same discharge form (index date for metastatic cancer). Incidence of metastasis was ascertained by the absence in two years before this index date. Chemo/radiotherapy in the accrual (index date for relapsing cancer) identified relapse events, if it was administered at least 6 months after the last treatment occurred in the previous period. Patients were characterized by gender, age and comorbidities of interest. Two-year hospitalizations, outpatient specialist care and healthcare costs were analysed, in the NHS perspective. One-year disease progression was identified as further chemo/radiotherapy use or newly hospital diagnosed metastasis.
Results
Out of >7 million inhabitants in 2015, 126 adults (2.0x100,000 inhabitants) had relapsing or metastatic H&N cancer. Males were the 89.7%. Mean age (±SD) was 63±11. Mainly men and elders had comorbidities: arterial hypertension was the most common one (45.2% of the cohort). During the last life month of died subjects, the NHS spent €2,668/patient. In the first follow-up year, mean overall cost per patient was €15,781, while €7,458 in the second one (n=79 subjects alive). Hospitalizations accounted for the highest expenditure. In 1-year follow-up, the disease progressed for 14 patients (11.1% of the cohort). On average, each subject with/without disease progression yearly costed €14,791/€15,904, considering the whole clinical and demographic picture.
Conclusions
In the light of the evolving diagnostic and therapeutic options for subjects with H&N cancer, the real-world evidence at the healthcare management service can help optimize patient outcomes and clinician resources.
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