Head and Neck Cancers Coverage from Every Angle

Financial Burden of Head and Neck Versus Other Cancers

By: Melissa E. Fryman, MS
Posted: Tuesday, March 12, 2019

According to a study by Sean T. Massa, MD, of the Washington University, St. Louis, and colleagues, patients with head and neck cancer are disproportionately affected by their medical expenses. Although it is known that cancer care is linked to a high financial burden, this analysis, published in JAMA Otolaryngology–Head & Neck Surgery, is reportedly the first to directly compare the financial and expense profiles of patients with head and neck cancer with those of other patients with cancer.

“Patients with head and neck cancer are uniquely disenfranchised and have higher medical expenses, which cumulatively increases their risk for financial burdens incurred by medical treatments,” concluded the authors.

In this retrospective review of more than 18 years of data from the Medical Expenditure Panel Survey, a total of 444,867 adults were surveyed, with 16,771 individuals reporting a history of cancer and 489 (3%) reporting head and neck cancer. Statistical methodologies used included regression modeling and weighting using balanced repeated replication.  

The median annual medical expenses, as well as the relative out-of-pocket expenses, were higher for patients with head and neck cancer versus those with other cancers. Unemployment, public insurance, poverty, and lower health status were associated with higher relative out-of-pocket expenses. In terms of total expenses, Asian patients incurred lower median expenses than white patients, and Midwesterners incurred lower expenses than Westerners and Northwesterners. Individuals with excellent health also paid much less than those with poor health.

“The individual’s financial burden from out-of-pocket expenses depends more on income than health, demographics, or even insurance status,” wrote the authors. “These findings are important for practitioners discussing financial burden with patients, yet most oncologists are uncomfortable having these discussions despite the recommendations to discuss the financial implications of cancer with patients and patients’ desire to hear this information.”

Disclosure: The study authors’ disclosure information may be found at jamanetwork.com.


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