Future Inpatient Cost Burden of Laryngeal Cancer in Romania: Aging, Residence, and Prevention Scenarios in a Nationwide Ecological Study

Background and Objectives: Laryngeal cancer imposes substantial inpatient costs in middle-income health systems. We described recent trends in laryngeal cancer hospitalizations in Romania, estimated hospital expenditure, and modeled the impact of prevention scenarios to 2035. Methods: We conducted an ecological analysis of 20,056 discharges diagnosed as laryngeal cancer (ICD-10 C32.x) between 2019 and 2023. Each episode was assigned a mean unit cost of 1100 USD, with age- and residence-specific adjustments, and re-priced using EU (3900 USD) and US (30,000 USD) tariffs. We derived annual costs and projected 2035 expenditure under three prevention scenarios. Results: Annual discharges fell from 5408 in 2019 to 3151–3212 in 2020–2021, then rose to 4409 in 2023, while inpatient spending ranged from 3.47 to 5.95 million USD, reaching 4.85 million USD in 2023 (22,200 USD/100,000 population). Re-pricing 2023 activity at EU and US unit costs yielded counterfactual totals of 17.20 and 132.27 million USD. Older adults (≥65 years) generated 47.6% of discharges and 49.1% of spending in 2023, and urban residence increased the odds of age ≥65 by 48% (OR 1.48, 95% CI 1.40–1.57). Without new prevention, costs are projected to reach 12.60 million USD by 2035; a 30% smoking reduction and a combined package including radon mitigation and dysphonia screening would lower 2035 costs to 10.33 and 9.07 million USD. Conclusions: Demographic aging and sustained case volume will markedly increase hospital costs, while prevention scenarios are associated with lower projected inpatient expenditure.