Access to Hormonal Breast Cancer Therapy Increased in Medicaid-Expanded States

Coverage of hormonal breast cancer therapies increased in states that expanded Medicaid compared with non-expansion states during 2011 to 2017, according to a new study.
The findings were presented at the 11th AACR Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved.
For the study, the researchers used data from the Medicaid State Drug Utilization Database (SDUD), which was compiled by the Centers for Medicare and Medicaid Services. They analyzed outpatient prescription rates and associated payments for hormonal therapies tamoxifen and aromatase inhibitors for patients with breast cancer enrolled in Medicaid programs.
According to the data, prescriptions for all hormonal therapy medications and aromatase inhibitors increased by 27% and 29%, respectively, in Medicaid programs among states that expanded Medicaid, compared with Medicaid programs in non-expansion states. The study included both generic and branded prescriptions.
Hormonal therapies can reduce an individual’s chance of their breast cancer returning and should be taken for 3 to 5 years to be most effective, the researchers noted. The study also found that the difference in the rate of hormonal therapy between states that underwent Medicaid expansion and those that did not continued to rise over the course of more than a year following Medicaid expansion. The researchers noted that limitations of the study include reliance on state level Medicaid prescription data.
“This highlights that getting the coverage for as a 1-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,” Michael Halpern, MD, PhD, associate professor at Temple University College of Public Health, said in a statement.
According to Dr Halpern, the findings indicate that states that expanded Medicaid funded increased access to these hormonal therapies and that use of these therapies increased among women who were previously uninsured and did not have access. 
“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 the medications that they need to prevent their cancer from coming back,” Dr Halpern said.
A previous study indicated that Medicaid expansion could also improve breast cancer screening rates. The study showed that low-income women were more likely to receive a mammogram compared with women in states without Medicaid expansion.
Coverage of Hormonal Breast Cancer Therapies Increased in States That Expanded Medicaid [news release]. AACR’s website. Accessed November 5, 2018.

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