The Economic Burden of Cancer Care

With the exception of certain rare diseases, perhaps no disease presents a greater economic burden than cancer, and it shows no signs of slowing down. In fact, spending on cancer treatments alone exploded from $26.8 billion in 2011 to $42.1 billion in 2016 (adjusted for inflation of the American dollar in 2016), according to a study published in the Journal of Oncology Practice.

In the case of head and neck cancer (HCN), healthcare spending has increased in recent years. One major culprit is the costs of systemic therapy and increased use of such pharmacological agents such as biologics, chemotherapy, immunotherapy, and target therapies-all treatments that tend to carry high prices tags.

Additionally, treating the side effects stemming from cancer treatment creates additional economic challenges. In this arena, common solid tumors capture large portions of the market share; metastatic breast cancer in women less than 65 years of age having exceeded more than an estimated $572 million in indirect societal costs alone, according to a 2016 study following 1,682 patients. More than half of these patients (54%) experienced at least one adverse event stemming from chemotherapy. Among these side effects are anemia, neutropenia, infections, pyrexia, and gastrointestinal toxicities.

Related article: Solid Tumors: What Pharmacists Need to Know

On the other end of the spectrum are the less-common HCNs. Head and neck cancers (HCN) represent 3% of all newly cancers diagnoses and 2% of all cancer-related deaths in the United States; however, there is limited data on the costs associated with treating cancer-induced side effects.

With HCN, hospitalizations and other forms of medical care required to address treating both acute and long-term adverse effects stemming from systemic oncological therapy also contribute to the surge in spending.

Previous estimates of economic burden associated with HNC were underestimated  and overstated, owing to the fact that these studies did not include newly approved agents. Additional factors contributing to underestimated numbers included the fact that many studies involved single pharmacological agents or specific adverse events.

A recent study found that nearly half (41.9%) of patients found to have adverse events of any sort. The results were presented in a poster at the Academy of Managed Care Pharmacy Nexus 2019 meeting in October. Of these patients more of them experienced gastrointestinal disturbances than any other side effect, reported in 20.9% of patients involved in the study. Infections and nervous system disorders tied for second place with 12.6% of patients who had side effects experiencing side effects that affected these conditions.

More studies are needed to better quantify the total costs associated with cancer treatment in different types of solid tumors.