Impact of monoclonal antibody therapy for head and neck cancer on end-of-life care utilization and costs.

ABSTRACT

BACKGROUND: The impact of monoclonal antibody therapy (mAB) for advanced head and neck cancer on end-of-life health care utilization and costs has yet to be adequately studied. METHODS: Retrospective cohort study of patients aged 65 and over with a diagnosis of head and neck cancer between 2007 and 2017 within the SEER-Medicare registry assessing the impact of mAB therapy (i.e., cetuximab, nivolumab, or pembrolizumab) on end-of-life health care utilization (ED visits, inpatient admissions, ICU admissions, and hospice claims) and costs. RESULTS: Of 12 544 patients with HNC, 270 (2.2%) utilized mAB therapy at the end-of-life period. On multivariable analyses adjusting for demographic and clinicopathologic characteristics, there was a significant association between mAB therapy and emergency department visits (OR 1.38, 95% CI 1.1-1.8, p = 0.01) and healthcare costs (ß $9760, 95% CI 5062-14 458, p < 0.01). CONCLUSIONS: mAB use is associated with higher emergency department utilization and health care costs potentially due to infusion-related and drug toxicity expenses.