TY - JOUR
T1 - Health care costs of anal cancer in a commercially insured population in the United States
AU - Wu, Chi Fang
AU - Xu, Li
AU - Fu, Shuangshuang
AU - Peng, Ho Lan
AU - Messick, Craig A.
AU - Lairson, David R.
N1 - Publisher Copyright:
Copyright © 2018, Academy of Managed Care Pharmacy. All rights reserved.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - BACKGROUND: The incidence and death rate of anal cancer in the United States has been increasing on average 2%-3% per year over the past 10 years. Human papillomavirus (HPV) vaccination is a potentially viable prevention strategy, since about 80% of anal cancers are attributable to HPV. To understand the effect of HPV vaccination, it is important to estimate the treatment costs for the HPV-related disease. OBJECTIVE: To estimate the 2-year per patient mean direct health care costs associated with anal cancer in a commercially insured population in the United States. METHODS: All newly diagnosed anal cancer patients were identified from a 2011-2014 Truven MarketScan database. Matched population controls were selected from the database with a 2-step matching method using demographic, comorbidity, and health care cost variables. Costs for the first 2 years were measured for cancer patients and controls. The difference in costs between the groups was calculated to estimate the costs associated with anal cancer treatment. A generalized linear model with gamma distribution and log link function was applied to estimate the costs for censored months for the patients who did not have at least 2 years of follow-up. RESULTS: 1,976 patients with anal cancer and 1,976 controls were included in the study. The first 2-year per patient adjusted mean cost associated with anal cancer treatment was $127,531 (SD=$189,064). Male sex, cancer diagnosis, higher Charlson Comorbidity Index score, and higher prediagnosis costs were significantly associated with higher monthly costs. Higher psychiatric diagnostic group scores were associated with lower monthly costs. Anal cancer treatment costs were highest in the first 6 months after diagnosis (per patient per month [PPPM] mean=$12,846), leveling off at a much lower monthly cost during the subsequent 18 months of the 2-year period (PPPM mean=$3,717). CONCLUSIONS: The first 2-year costs associated with anal cancer treatment were substantial. Given that approximately 80% of anal cancers are attributable to HPV infection, this study provides important parameters for estimating the potential economic benefit of HPV vaccination.
AB - BACKGROUND: The incidence and death rate of anal cancer in the United States has been increasing on average 2%-3% per year over the past 10 years. Human papillomavirus (HPV) vaccination is a potentially viable prevention strategy, since about 80% of anal cancers are attributable to HPV. To understand the effect of HPV vaccination, it is important to estimate the treatment costs for the HPV-related disease. OBJECTIVE: To estimate the 2-year per patient mean direct health care costs associated with anal cancer in a commercially insured population in the United States. METHODS: All newly diagnosed anal cancer patients were identified from a 2011-2014 Truven MarketScan database. Matched population controls were selected from the database with a 2-step matching method using demographic, comorbidity, and health care cost variables. Costs for the first 2 years were measured for cancer patients and controls. The difference in costs between the groups was calculated to estimate the costs associated with anal cancer treatment. A generalized linear model with gamma distribution and log link function was applied to estimate the costs for censored months for the patients who did not have at least 2 years of follow-up. RESULTS: 1,976 patients with anal cancer and 1,976 controls were included in the study. The first 2-year per patient adjusted mean cost associated with anal cancer treatment was $127,531 (SD=$189,064). Male sex, cancer diagnosis, higher Charlson Comorbidity Index score, and higher prediagnosis costs were significantly associated with higher monthly costs. Higher psychiatric diagnostic group scores were associated with lower monthly costs. Anal cancer treatment costs were highest in the first 6 months after diagnosis (per patient per month [PPPM] mean=$12,846), leveling off at a much lower monthly cost during the subsequent 18 months of the 2-year period (PPPM mean=$3,717). CONCLUSIONS: The first 2-year costs associated with anal cancer treatment were substantial. Given that approximately 80% of anal cancers are attributable to HPV infection, this study provides important parameters for estimating the potential economic benefit of HPV vaccination.
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U2 - 10.18553/jmcp.2018.24.11.1156
DO - 10.18553/jmcp.2018.24.11.1156
M3 - Article
C2 - 30362917
AN - SCOPUS:85055615108
SN - 2376-0540
VL - 24
SP - 1156
EP - 1164
JO - Journal of Managed Care and Specialty Pharmacy
JF - Journal of Managed Care and Specialty Pharmacy
IS - 11
ER -