Abstract:
PURPOSE:The objective of this study is to understand an impact of financial burden on the adjuvant hormonal therapy (AHT) adherence and persistence for insured women aged 18-64 with early breast cancer in Texas. METHODS:We conducted a retrospective cohort study using claims data for population insured by Blue Cross Blue Shield of Texas from the year 2008 to 2013. Outcomes include adherence to adjuvant hormonal therapy, which was measured by medication possession ratio and persistence on AHT, which is the duration of time from initiation to discontinuation of therapy. Multivariate logistic regression models with repeated regional-level adjustments were used to explore the odds of AHT adherence. Cox proportional hazards model was conducted to assess time to the first 90+-day gap for persistence and a Kaplan-Meier curve were used to estimate probabilities to calculate the percentages of women who experienced 90+-day gaps in AHT. RESULTS:Of the 938 women in the cohort, 627 (66.8%) initiated the treatment. By year 1, 66.9% of women were adherent to the therapy, and by year 5, only 29% of those were adherent. The percentage of women with no gap in therapy greater than 90 days was 80.8%. Both higher out-of-pocket costs spent on all prescription drugs except AHT and AHT-specific out-of-pocket costs were negatively associated with adherence to AHT as well as continuing AHT as recommended. CONCLUSIONS:Financial burdens including both non-AHT medication and AHT-specific out-of-pocket costs were significantly associated with adherence and persistence to the therapy.
journal_name
Breast Cancer Res Treatjournal_title
Breast cancer research and treatmentauthors
Kim J,Rajan SS,Du XL,Franzini L,Giordano SH,Morgan ROdoi
10.1007/s10549-018-4704-3subject
Has Abstractpub_date
2018-06-01 00:00:00pages
573-586issue
3eissn
0167-6806issn
1573-7217pii
10.1007/s10549-018-4704-3journal_volume
169pub_type
杂志文章abstract::It is common belief among physicians the idea that breast cancer was not diagnosed centuries ago. Nevertheless, there are reports suggesting that old masters and even common people knew this dramatic disease. In the 16th and 17th centuries, famous artists painted things exactly as they saw them. This allows the detect...
journal_title:Breast cancer research and treatment
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journal_title:Breast cancer research and treatment
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doi:10.1007/BF01806082
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journal_title:Breast cancer research and treatment
pub_type: 杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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