Medical Costs and HPV Vaccination in Oropharyngeal Cancer

Key Points

  • The average cost of the first 2 years of health care in the treatment of oropharyngeal cancer in Texas is $139,749.
  • Oropharyngeal cancer is the most common HPV-related cancer—from 2008 to 2012, 11,000 new cases annually in the United States were attributed to HPV. Despite an effective vaccine for HPV-related cancers, just 41% of girls and 24% of boys in Texas had completed the HPV vaccination series in 2015, about the same as the national rate.
  • The cost estimates of treating oropharyngeal cancer provide parameters for the development of decision-analytic models to inform decision-makers about the potential value of initiatives for increasing the HPV rate in Texas. 

According to the Centers for Disease Control and Prevention, human papillomavirus (HPV)-related cancers, including oropharyngeal, vulvar, cervical, vaginal, penile, anal, and rectal cancers, have increased in recent years, with oropharyngeal cancer the most common HPV-related cancer—from 2008 to 2012, 11,000 new cases annually in the United States were attributed to HPV. Although the HPV vaccine is highly effective at preventing oncogenic infections and HPV-related premalignancies, the HPV immunization rate among Texas youth aged 13 to 17 years is low—just 41% of girls and 24% of boys—similar to rates across the nation, and the health-care cost of treating oropharyngeal cancer in the state is unknown.

Now a study by Lairson et al investigating the first 2 years of health-care cost in the treatment of new cases of oropharyngeal cancer among commercially insured patients in Texas has found that cost to be $139,749. The cost estimates provide parameters for the development of decision-analytic models to inform decision-makers about the potential value of initiatives for increasing the HPV immunization rate in the state, according to the researchers. The study was published in Cancer Epidemiology, Biomarkers & Prevention.

Study Methodology

To estimate the average 2-year cost of treatment of oropharyngeal cancer in Texas, the researchers analyzed data from the 2011–2014 Truven MarketScan Commercial Claims and Encounters Database, which predominantly contains enrollment and health-care claims data for patients with commercial health insurance. The researchers' analysis included data from 467 patients with oropharyngeal cancer diagnosed from 2011 to 2014 and a control group of 467 noncancer patients obtained with propensity score matching.

The total health-care cost during the first 2 years after the index rate was measured. A generalized linear model was used to identify predictors of monthly cost during the 2 years after the index date.

Study Findings

The researchers found that the mean differential adjusted health-care cost for oropharyngeal cancer was $139,749 in the first 2 years, which was higher than in previous studies. The mean adjusted monthly cost during the first 2 years was $6,693 for those with oropharyngeal cancer ($160,639 for the 2 years) and $870 ($20,890 for the 2 years) for those without. Age, commorbidity, mental health, prediagnostic health-care cost, and time index were significant predictors of monthly cost.

Among the patients with oropharyngeal cancer, the majority of the costs were for outpatient services. The mean unadjusted cost for outpatient services was $106,604; the mean unadjusted costs for inpatient services and prescription drugs were $42,341 and $3,550, respectively.

Reducing Costs and Saving Lives by Preventing HPV-Related Cancers

“The mean adjusted difference in health-care costs between cases and controls provides the primary estimate of the mean cost of treating a patient with oropharyngeal cancer in Texas,” said David R. Lairson, PhD, Professor of Health Economics at The University of Texas Health Science Center at Houston and lead author of this study, in a statement. “This provides an estimate of the potential savings per case that can be avoided by HPV immunization, which is highly relevant to HPV immunization policy assessment. Of note, we did not estimate lost productivity due to oropharyngeal cancer, which is the cost in addition to medical care.”

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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