2308 - Cost Burden of Non-Metastatic Cervical Cancer in a Commercially Insured US Population: A National Claims-Based Analysis

Purpose/Objective(s): Cervical cancer affects approximately 13,500 women in the United States annually, yet the real-world economic burden across the full spectrum of disease management remains poorly characterized. We quantified all-cause healthcare costs for patients with non-metastatic cervical cancer relative to cancer-free matched controls using 14 years of national claims data.

Materials/Methods: Using the IBM MarketScan Commercial Claims and Encounters database (2009-2022), we identified females with a new cervical cancer diagnosis (ICD-9: 180.x; ICD-10: C53.x), age =18, with pharmacy benefit coverage, no metastatic disease (ICD-9: 196.x-198.x, 199.0-1; ICD-10: C77.x-C79.x, C80.0-1), and continuous enrollment 6 mos pre- and 12 mos post-diagnosis. Cases were matched 1:5 to cancer-free female controls on diagnosis year, age, metropolitan statistical area, and pharmacy coverage, with each control permitted to serve in only one matched set. Total healthcare costs were assessed for 3 different time periods: 6 mos pre- and 12 mos post-diagnosis, and the combined 18 month window. All costs were inflation-adjusted to 2022 USD (CPI-U). Unadjusted comparisons used Wilcoxon rank-sum tests. Cost ratios (CRs) were estimated via generalized linear models with a gamma distribution and log link.

Results: The cohort included 15,641 cases and 78,205 matched controls (N=93,846). Mean age was 46.93 years (SD 10.83), perfectly balanced by design. Cardiopulmonary comorbidities (10.8% vs. 7.9%), diabetes (8.1% vs. 6.5%), and liver/renal disease (1.7% vs. 0.8%) were more prevalent among cases than controls (all p<0.0001), though effect sizes were small (Cramer's V <0.05). Unadjusted median 18-month total gross costs were $20,472 (IQR $7,003-$49,558) for cases versus $3,900 (IQR $1,316–$11,001) for controls (p<0.0001). Cases incurred 3.57 times the gross total costs of controls over 18 months (least squares mean: $41,974 vs. $11,759; p<0.0001), with a 12-month post-diagnosis CR of 4.07 ($33,003 vs. $8,098; p<0.0001). Patient out-of-pocket (OOP) CRs were 1.90 at 18 months ($3,619 vs. $1,908) and 1.94 at 12 months post-diagnosis ($2,540 vs. $1,306; both p<0.0001). Pre-diagnosis costs were also significantly elevated (6-month gross CR 2.27; OOP CR 1.64; both p<0.0001), consistent with diagnostic workup burden preceding diagnosis.

Conclusion: In our matched case-control analysis of all cause healthcare costs in a commercially insured US population, a new cervical cancer diagnosis was associated with a 3.6-fold increase in total healthcare costs and a 4.1-fold increase in the 12 months following diagnosis. Patient OOP costs were nearly double those of cancer-free controls. Elevated costs detected 6 months prior to diagnosis highlight that the economic burden begins pre-treatment. These findings provide a population-level benchmark for cervical cancer cost burden to support cost-effective analyses and to guide early financial navigation interventions for this patient population.