Direct medical cost of oropharyngeal cancer among patients insured by Medicaid in Texas. (September 2019)

• Record Type: Journal Article
• Authors: Zhao, Bo; Fu, Shuangshuang; Wu, Chi-Fang; Dahlstrom, Kristina R.; Fokom Domgue, Joël; Tam, Samantha; Xu, Li; Sturgis, Erich M.; Lairson, David R.
• Is Part Of: Oral oncology. Volume 96(2019)
• Page Start: 21
• Page End: 26
• Publication Date: 2019-09
• Subjects: Healthcare costs -- Medicaid -- Oropharyngeal cancer -- Texas; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2019.06.033
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Mean incremental first-year cost of oropharyngeal cancer in Texas Medicaid was $45, 102. Mean incremental second-year cost of oropharyngeal cancer in Texas Medicaid was $11, 684. Costs were associated with higher comorbidity and pre-cancer cost. Costs incurred by Medicaid were lower for dual Medicare-Medicaid enrollees. Abstract: Objectives: The aim of this study was to estimate the direct 2-year mean incremental medical care costs for incident oropharyngeal cancer (OPC) from the perspective of the Texas Medicaid program. Methods: OPC patients treated from 2008 to 2012 were selected in the Texas Medicaid database. Using a two-step 1:1 propensity score matching method, we selected controls to determine the differential cost associated with OPC. Monthly and yearly direct costs were estimated for 2 years after the cancer diagnosis. For patients without 2-year complete follow-up, a generalized linear model with gamma distribution and log link function was applied to predict costs for the censored months. Results: A total of 352 patients with OPC and the same number of controls were included in the study. Among OPC patients, 204 (58%) were covered by Medicaid and Medicare, and 148 patients (42%) were insured under Medicaid only. The adjusted first- and second-year mean differential costs were $45, 102 and $11, 684 for Medicaid-only enrollees and $5734 and $2162 for Medicaid-Medicare dual-eligible enrollees, respectively. Being male, Hispanic, Medicaid-only eligible, living in the Harlingen region, and having more comorbidities were positively associated with monthly cost. Lubbock residents experienced lower costs. Conclusions: The direct incremental medical costs associated with OPCs among patients insured by Texas Medicaid were substantial in the first 2 years after cancer diagnosis and should be considered in assessing the economic consequences of increasing the investment in HPV vaccination in Texas.