Patient costs of breast cancer endocrine therapy agents under Medicare Part D vs with generic formulations. Springerplus 2015;4(1):54
Date
02/13/2015Pubmed ID
25674506Pubmed Central ID
PMC4320689DOI
10.1186/s40064-015-0827-8Scopus ID
2-s2.0-84923230004 (requires institutional sign-in at Scopus site) 11 CitationsAbstract
PURPOSE: The high expense of newer, more effective adjuvant endocrine therapy agents (aromatase inhibitors [AIs]) for postmenopausal breast cancer contributes to socioeconomic disparities in breast cancer outcomes. This study compares endocrine therapy costs for breast cancer patients during the first five years of Medicare Part D implementation, and when generic alternatives became available.
METHODS: The out of pocket patient costs for AIs and tamoxifen under Medicare Part D drug plans were determined for 2006-2011 from the CMS Website for the 50 US states and District of Columbia.
RESULTS: Between 2006 and 2010, the mean annual patient drug cost under Medicare Part D in the median state rose 19% for tamoxifen, 113% for anastrozole, 89% for exemestane, and 129% for letrozole, resulting in median annual out of pocket costs in 2010 of $701, $3050, $2804, and $3664 respectively. However, the 2011 availability of generic AI preparations led to median annual costs in 2011 of $804, $872, $1837, and $2217 respectively. Not included in the reported patient costs, the mean monthly drug premiums in the median state increased 58% in 2011 compared to 2007.
CONCLUSIONS: The more effective AI agents became considerably more expensive during the first several years of the Medicare Part D program. Cost decreased with the introduction of generic agents, an intervention that was independent of the Part D program. It is unlikely that the Part D program ameliorated existing socioeconomic disparities in survival among breast cancer patients, but the availability of generic agents may do so.
Author List
Nattinger AB, Pezzin LE, McGinley EL, Charlson JA, Yen TW, Neuner JMAuthors
John A. Charlson MD Associate Professor in the Medicine department at Medical College of WisconsinAnn B. Nattinger MD, MPH Associate Provost, Professor in the Medicine department at Medical College of Wisconsin
Joan Neuner MD, MPH Professor in the Medicine department at Medical College of Wisconsin
Liliana Pezzin PhD, JD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Tina W F Yen MD, MS Professor in the Surgery department at Medical College of Wisconsin
