title: Healthcare resource use and costs associated with cervical, vaginal and vulvar cancers in a large U.S. health plan.
abstract: OBJECTIVE
  To estimate healthcare resource utilization and costs of cervical, vulvar and vaginal cancers in a large U.S. health plan.
  
  
  METHODS
  We estimated incremental ambulatory visits, hospitalizations, prescription fills and healthcare costs for cancer cases relative to population controls. Data for cervical (n=2788), vulvar (n=621) and vaginal cancer (n=254) cases and an identical number of controls were obtained from a large U.S. health plan. Cases were identified via diagnostic codes on a healthcare claim and matched to controls. Incremental resource use was assessed using a two-stage regression method developed by Carides, with costs analyzed using Lin's regression method.
  
  
  RESULTS
  Through 4 years of follow-up, cervical cancer patients had incremental resource use of 12.0 ambulatory visits, 0.6 hospital admissions and 7.0 prescription fills per case. Cumulative 4-year incremental healthcare costs per case ranged from $8236 for vulvar cancers to $18,799 for cervical cancers. When adjusted to cervical, vulvar and vaginal cancer excess mortality rates observed within the U.S. Surveillance Epidemiology and End Results program, estimated incremental costs were $29,649 for cervical, $11,356 for vulvar and $21,963 for vaginal cancers. There was a significant upward trend in costs with increasing age for cervical cancer, however trends were less consistent for vulvar and vaginal cancers.
  
  
  CONCLUSIONS
  Direct medical costs associated with cervical, vulvar and vaginal cancers were observed to be substantial. These data can help inform evaluations of the economic burden and cost-effectiveness of prevention of these cancers, particularly for vulvar and vaginal disease, where such data have not been previously reported.
authors.affiliation: Department of Health Economic Statistics, Merck Research Laboratories, North Wales, PA, USA.
authors.forename: Ralph P
authors.initials: RP
authors.lastname: Insinga
authors.forename: Xin
authors.initials: X
authors.lastname: Ye
authors.forename: Puneet K
authors.initials: PK
authors.lastname: Singhal
authors.forename: George W
authors.initials: GW
authors.lastname: Carides