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March 11, 2015
Net Worth Affects Adherence to Breast Cancer
Hormonal Therapy New York—When trying to improve adherence to hormonal therapy among patients with breast cancer, it is important to look at net worth not just income, according to a new study. The research, published in the Journal of Clinical Oncology, emphasizes that household net worth is a major factor, although often overlooked, in adherence to hormonal therapy among patients with breast cancer and even helps explain racial disparities in quality of care. “We know that oral hormonal therapy can reduce the recurrence of hormone receptor-positive breast cancer by 50% percent. Yet up to 10% of patients discontinue therapy annually, and only about half finish the recommended five-year course of therapy. Thus, it’s imperative that we understand what is preventing women from taking their medications and what we can do to improve adherence,” said lead author Dawn Hershman, MD, MS, associate professor of medicine at the College of Physicians and Surgeons and associate professor of epidemiology at the Mailman School of Public Health, Columbia University Medical Center. While some past studies have demonstrated that disparities in income contribute to difference in healthcare usage among racial and ethnic groups, the effect of household net worth on quality of care had not been specifically analyzed in breast cancer patients. Seeking to find out more about the association, the researchers collected prescription and financial data on 2,473 women ages 50 and older with early-stage breast cancer who had been prescribed aromatase between 2007 and 2011. Net worth was divided into three categories: low ($250,000 or less), moderate ($250,000 to $750,000), and high ($750,000 or more). Financial factors, such as income and net worth, were found to be directly associated with adherence to hormonal therapy. The researchers also point out that, although black race was associated with decreased adherence, when they controlled for net worth, there was no racial difference in adherence in the moderate- and high-net-worth groups. “This suggests that income may be an inadequate assessment of financial resources,” Hershman said. “This is particularly true for the elderly, for whom net worth seems to be a more accurate measure of socioeconomic differences in use of healthcare services.” The average monthly cost of generic aromatase inhibitors is $150, while the average monthly cost of oral biologics ranges from $5,000 to $8,000, the study points out. The authors suggest that healthcare providers should ask patients about their ability to pay for their medications. “Many patients aren’t comfortable raising this issue and just discontinue therapy if they can’t afford it,” Hershman said. “By engaging patients in conversation, we may be able to come up with a solution, perhaps by finding less expensive alternatives or by asking pharmaceutical companies to assist patients with co-payments.” |
U.S. Pharmacist Social Connect
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