Chemotherapy: Adherence Increased with Generic, Lower Cost Medications

Dawn L. Hershman, MD MS Associate Professor of Medicine and Interview with:
Dawn L. Hershman, MD MS
Associate Professor of Medicine and Epidemiology
Leader, Breast Cancer Program
Herbert Irving Comprehensive Cancer Center
Columbia University Medical Center What are the main findings of the study?

Dr. Hershman: We have found in the past that compliance to 5 years of hormone therapy for the adjuvant treatment of breast cancer is low. While toxicity is a main reason, other factors are also important. Recent studies suggest out of pocket costs are high among cancer patients. We evaluated the change in adherence to hormone therapy after the introduction of generic Aromatase inhibitors. We found that discontinuation decreased and adherence increased with generic aromatase inhibitors compared to brand name. we found that higher co-payments were associated with decreased adherence and increased discontinuation. We also found that patients in the highest income group were more likely to be adherent to hormone therapy. Were any of the findings unexpected?

Dr. Hershman: We were surprised that even after controlling for average co-payment amount, there was still more adherence with generic aromatase inhibitors than brand name or tamoxifen. What should clinicians and patients take away from your report?

Dr. Hershman: Clinicians should be aware that out of pocket costs may be a barrier to optimal treatment and should discuss ask patients if they are having a difficult time getting these life saving medications. What recommendations do you have for future research as a result of this study?

Dr. Hershman: With newer oral chemotherapy medications approaching up to $10,000 a month, research needs to focus on compliance and access to these drugs.


Source reference: Hershman DL, et al “The change from brand-name to generic aromatase inhibitors and hormone therapy adherence for early stage breast cancer” SABCS 20131; Abstract S3-04.