Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.

<h4>Objective</h4>To examine the different levels of copayment assistance and treatment adherence among Medicare and Medicaid dual eligible beneficiaries with breast cancer in the U.S.<h4>Research design</h4>Propensity Score methodology was adopted to minimize potential selec...

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Autores principales:	Siyu Ma, Donald S Shepard, Grant A Ritter, Robert E Martell, Cindy Parks Thomas
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/651cb1481c1349cb82aa6c816ba78863
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spelling	oai:doaj.org-article:651cb1481c1349cb82aa6c816ba788632021-12-02T20:11:18ZCost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.1932-620310.1371/journal.pone.0250967https://doaj.org/article/651cb1481c1349cb82aa6c816ba788632021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0250967https://doaj.org/toc/1932-6203<h4>Objective</h4>To examine the different levels of copayment assistance and treatment adherence among Medicare and Medicaid dual eligible beneficiaries with breast cancer in the U.S.<h4>Research design</h4>Propensity Score methodology was adopted to minimize potential selection bias from the nonrandom allocation of the treatment group (i.e., full Medicaid beneficiaries) and control group (i.e., Medicare Savings Programs [MSPs] beneficiaries). Longitudinal hierarchical model and Cox proportional-hazard model were adopted to examine patients' adherence over their full five-year course of adjuvant hormone therapy.<h4>Results</h4>Our study cohort consisted of 1,133 dual eligible beneficiaries diagnosed with hormone receptor-positive early stage breast cancer in years 2007 -mid 2009. About 80.5% of them received MSPs benefits, while the rest received full Medicaid benefits. On average for a standardized 30-day hormone therapy medication, full Medicaid beneficiaries spent $0.5-$2.0 and MSP beneficiaries spent $1.4-$4.8 in copayment. After adjusting for other factors, this copayment reduction wasn't associated with a significantly better adherence. However, when the catastrophic coverage threshold was reached (copayments reduced to zero), significant improvement in adherence was found in both groups.<h4>Conclusions</h4>Our study found that small amount of cost-sharing reduction did not affect Medicare and Medicaid dual eligible patients' medication treatment adherence, however, the elimination of cost-sharing (even a minimal amount) was associated with improved adherence. Future legislative and advocacy efforts should be paid on eliminating cost sharing for dual eligibles, and possibly even a broader group of financially vulnerable patients.Siyu MaDonald S ShepardGrant A RitterRobert E MartellCindy Parks ThomasPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0250967 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Siyu Ma Donald S Shepard Grant A Ritter Robert E Martell Cindy Parks Thomas Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.
description	<h4>Objective</h4>To examine the different levels of copayment assistance and treatment adherence among Medicare and Medicaid dual eligible beneficiaries with breast cancer in the U.S.<h4>Research design</h4>Propensity Score methodology was adopted to minimize potential selection bias from the nonrandom allocation of the treatment group (i.e., full Medicaid beneficiaries) and control group (i.e., Medicare Savings Programs [MSPs] beneficiaries). Longitudinal hierarchical model and Cox proportional-hazard model were adopted to examine patients' adherence over their full five-year course of adjuvant hormone therapy.<h4>Results</h4>Our study cohort consisted of 1,133 dual eligible beneficiaries diagnosed with hormone receptor-positive early stage breast cancer in years 2007 -mid 2009. About 80.5% of them received MSPs benefits, while the rest received full Medicaid benefits. On average for a standardized 30-day hormone therapy medication, full Medicaid beneficiaries spent $0.5-$2.0 and MSP beneficiaries spent $1.4-$4.8 in copayment. After adjusting for other factors, this copayment reduction wasn't associated with a significantly better adherence. However, when the catastrophic coverage threshold was reached (copayments reduced to zero), significant improvement in adherence was found in both groups.<h4>Conclusions</h4>Our study found that small amount of cost-sharing reduction did not affect Medicare and Medicaid dual eligible patients' medication treatment adherence, however, the elimination of cost-sharing (even a minimal amount) was associated with improved adherence. Future legislative and advocacy efforts should be paid on eliminating cost sharing for dual eligibles, and possibly even a broader group of financially vulnerable patients.
format	article
author	Siyu Ma Donald S Shepard Grant A Ritter Robert E Martell Cindy Parks Thomas
author_facet	Siyu Ma Donald S Shepard Grant A Ritter Robert E Martell Cindy Parks Thomas
author_sort	Siyu Ma
title	Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.
title_short	Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.
title_full	Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.
title_fullStr	Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.
title_full_unstemmed	Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.
title_sort	cost sharing for breast cancer hormone therapy: how do dual eligible patients' copayment impact adherence.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/651cb1481c1349cb82aa6c816ba78863
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Cost sharing for breast cancer hormone therapy: How do dual eligible patients' copayment impact adherence.

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