Coverage of hormonal breast cancer therapies increased in states that expanded Medicaid

November 02, 2018

NEW ORLEANS -- An evaluation of breast cancer patients enrolled in Medicaid showed that states that expanded Medicaid during 2011 to 2017 had a 27 percent increase in prescriptions for hormonal therapy medications compared to states that did not expand Medicaid during the same period, according to results of a study presented at the 11th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved, held here Nov. 2-5.

"We saw a large and significant increase in the use of hormonal therapies for breast cancer treatment in states that underwent Medicaid expansion," said Michael Halpern, MD, PhD, associate professor at Temple University College of Public Health. "In contrast, states that did not participate in Medicaid expansion saw essentially no increase in these prescriptions."

For women who have received treatment for breast cancer and are recovering, hormonal therapies can reduce the chance of their breast cancer coming back, and, for best effect, they need to take these medications for three to five years, Halpern said.

"Over the course of more than a year following Medicaid expansion, the difference in the rate of hormonal therapy use between states that underwent Medicaid expansion and those that didn't continued to go up," noted Halpern. "This highlights that getting the coverage for these hormonal therapies as a one-time event isn't enough; there has to be a process where breast cancer survivors can work with their health care providers and get educated about the importance of this treatment."

Utilizing information from the Medicaid State Drug Utilization Database (SDUD) which was compiled by the Centers for Medicaid and Medicare (CMS), Halpern and colleagues evaluated outpatient prescription rates and associated payments for tamoxifen and aromatase inhibitors, two common hormonal therapeutics for the treatment of breast cancer, for individuals enrolled in Medicaid programs. Both generic and branded prescriptions were included in the study.

Following multivariable analysis, Halpern and colleagues found that prescriptions for all hormonal therapy medications and aromatase inhibitors increased by 27 percent and 29 percent, respectively, for Medicaid programs in states that expanded Medicaid, compared to Medicaid programs in non-expansion states. The study authors suggest that most of this increase was new utilization of these drugs that would not have occurred in the absence of Medicaid expansion.

"Looking at the medications funded by state Medicaid programs, it's clear that states that expanded Medicaid are funding increased access to these hormonal therapies," said Halpern. "We believe that hormonal therapy use increased among women who were previously uninsured and did not have access to these potentially life-saving drugs.

"While most women, regardless of their income or insurance status, have access to acute breast cancer treatments--initial surgery, chemotherapy, and/or radiation therapy--coverage is sometimes lacking for breast cancer survivors that may require long-term treatment with hormonal therapy," Halpern continued. "We need to be better at making sure that cancer survivors, particularly those who are in underserved populations, continue to have access to high-quality care and are able to receive the services and medications that they need to prevent their cancer from coming back."

Limitations of the study include a reliance on state level Medicaid prescription data; prescriptions for hormonal therapy could have been for conditions other than breast cancer, but this represents an extremely small cohort, noted Halpern.
This study was partly funded by the American Cancer Society. Halpern declares no conflict of interest.

American Association for Cancer Research

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to