Co-Pay Tied to Noncompliance for Breast Cancer Therapy

Degree of noncompliance with hormone therapy associated with increasing co-payments

THURSDAY, May 26 (HealthDay News) -- Higher prescription co-payments are associated with noncompliance with hormonal therapy for breast cancer, according to a study published online May 23 in the Journal of Clinical Oncology.

Alfred I. Neugut, M.D., Ph.D., from Columbia University in New York City, and colleagues investigated the impact of co-payments on noncompliance with adjuvant hormonal therapy among women with breast cancer. Participants included 8,110 women aged 50 to 65 years, and 14,050 women older than 65. All women were taking aromatase inhibitors for resected breast cancer and had two or more mail-order prescriptions over a period of two years. Noncompliance included nonpersistence (going more than 45 days without a medication refill) or nonadherence (a medication possession ratio less than 80 percent of eligible days).

The investigators found that 21.1 percent of women younger than 65 and 24.7 percent of women older than 65 were nonpersistent. Nonadherence was seen in 10.6 percent of women younger than 65 and 8.9 percent of women older than 65. A co-payment of $30 to $89.99, compared to one of less than $30, for a 90-day prescription was correlated with lower persistence in women aged 65 or older (odds ratio [OR], 0.69). A co-payment of more than $90 was associated with lower persistence in both age groups (younger than age 65 OR, 0.82; age 65 or older OR, 0.72). Nonadherence showed similar results.

"Increasing the amount of a prescription co-payment is associated with the degree of noncompliance to adjuvant aromatase inhibitor therapy in women with early-stage breast cancer," the authors write.

Two of the study authors disclosed financial ties to Medco Health Solutions.

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