2023-09-28 14:46:10 +00:00
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abstract: 'Purpose Over 50\% of breast cancer patients prescribed a 5-year course
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of daily oral adjuvant endocrine therapy (ET) are nonadherent. We
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investigated the role of costs and cancer medication delivery mode and
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other medication delivery factors on adherence. Methods We conducted a
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retrospective cohort study of commercially insured and Medicare
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advantage patients with newly diagnosed breast cancer in 2007-2015 who
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initiated ET. We examined the association between 12-month ET adherence
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(proportion of days covered by fills >= 0.80) and ET copayments, 90-day
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prescription refill use, mail order pharmacy use, number of pharmacies,
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and synchronization of medications. We used regression models to
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estimate nonadherence risk ratios adjusted for demographics (age,
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income, race, urbanicity), comorbidities, total medications, primary
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cancer treatments, and generic AI availability. Sensitivity analyses
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were conducted using alternative specifications for independent
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variables. Results Mail order users had higher adherence in both
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commercial and Medicare-insured cohorts. Commercially insured patients
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who used mail order were more likely to be adherent if they had low
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copayments (< \$5) and 90-day prescription refills. For commercially
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insured patients who used local pharmacies, use of one pharmacy and
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better synchronized refills were also associated with adherence. Among
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Medicare patients who used mail order pharmacies, only low copayments
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were associated with adherence, while among Medicare patients using
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local pharmacies both low copayments and 90-day prescriptions were
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associated with ET adherence. Conclusion Out-of-pocket costs, medication
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delivery mode, and other pharmacy-related medication delivery factors
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are associated with adherence to breast cancer ET. Future work should
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investigate whether interventions aimed at streamlining medication
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delivery could improve adherence for breast cancer patients.'
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affiliation: 'Neuner, JM (Corresponding Author), Med Coll Wisconsin, Div Gen Internal
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Med, Milwaukee, WI USA.
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Neuner, Joan M., Med Coll Wisconsin, Div Gen Internal Med, Milwaukee, WI USA.
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Neuner, Joan M.; Fergestrom, Nicole; Laud, Purushottam W., Med Coll Wisconsin, Ctr
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Adv Populat Sci, Milwaukee, WI USA.
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Pezzin, Liliana E., Med Coll Wisconsin, Inst Hlth \& Equity, Milwaukee, WI USA.
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Laud, Purushottam W., Med Coll Wisconsin, Div Biostatist, Milwaukee, WI USA.
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Ruddy, Kathryn J., Mayo Clin Rochester, Div Med Oncol, Rochester, MN USA.
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Winn, Aaron N., Med Coll Wisconsin, Sch Pharm, Milwaukee, WI USA.'
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author: Neuner, Joan M. and Fergestrom, Nicole and Pezzin, Liliana E. and Laud, Purushottam
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W. and Ruddy, Kathryn J. and Winn, Aaron N.
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author-email: jneuner@mcw.edu
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author_list:
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- family: Neuner
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given: Joan M.
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- family: Fergestrom
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given: Nicole
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- family: Pezzin
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given: Liliana E.
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- family: Laud
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given: Purushottam W.
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- family: Ruddy
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given: Kathryn J.
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- family: Winn
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given: Aaron N.
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da: '2023-09-28'
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doi: 10.1007/s10549-022-06704-2
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earlyaccessdate: NOV 2022
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eissn: 1573-7217
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files: []
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issn: 0167-6806
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journal: BREAST CANCER RESEARCH AND TREATMENT
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keywords: Breast cancer; Medication adherence; Cost-related nonadherence
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keywords-plus: 'HORMONAL-THERAPY; WOMEN; SYMPTOMS; SUPPORT; DISCONTINUATION;
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NONADHERENCE; TAMOXIFEN; SURVIVORS; CARE'
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language: English
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month: JAN
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number: '1'
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number-of-cited-references: '42'
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orcid-numbers: Neuner, Joan/0000-0003-0031-5988
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pages: 223-233
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papis_id: 7924be5e60cec03badb84c850ea1429f
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ref: Neuner2023medicationdelivery
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times-cited: '3'
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title: Medication delivery factors and adjuvant endocrine therapy adherence in breast
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cancer
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000882261500001
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usage-count-last-180-days: '0'
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usage-count-since-2013: '1'
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volume: '197'
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web-of-science-categories: Oncology
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year: '2023'
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