ArticleJournal of the National Cancer Institute2014
The change from brand-name to generic aromatase inhibitors and hormone therapy adherence for early-stage breast cancer.
Article in Journal of the National Cancer Institute, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
58 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of Adherence to Oral Antineoplastic Therapies.The oncologist · 2016Pooled it
- Financial Toxicity Monitoring in a Randomized Controlled Trial of Patient-Reported Outcomes During Cancer Treatment (Alliance AFT-39).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Trial
- Randomized Trial of Text Messaging to Reduce Early Discontinuation of Adjuvant Aromatase Inhibitor Therapy in Women With Early-Stage Breast Cancer: SWOG S1105.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2020Trial
- Is strict use of denosumab or zoledronate Beneficial to patients with bone metastatic Disease?Journal of bone oncology · 2026Article
- Self-Reported Adherence to Cancer Therapy: Development and Validation of the Domains of Subjective Extent of Nonadherence-Cancer Measure.JCO oncology practice · 2026Article
- High-Deductible Health Plans and Mortality Among Cancer Survivors.JAMA network open · 2026Article
- Cancer Immunotherapies: Navigating the Immune Landscape.Current cancer drug targets · 2026Review
- Hidden Costs of Endocrine Therapy for Black Breast Cancer Survivors: A Qualitative Examination of Patient and Provider Experiences.Clinical breast cancer · 2025Article
- Extended endocrine therapy use and decision making after breast cancer diagnosis.Journal of the National Cancer Institute · 2025Article
- Financial Distress in Genitourinary Cancer: Insights From CDC National Health Interview Survey.JCO oncology practice · 2024Article
- Survey on adverse events associated with drug therapy for breast cancer patients.BMC women's health · 2024Article
- Racial Disparity in Adherence to Endocrine Therapy among Women with Early-Stage Hormone Receptor Positive Breast Cancer: An Analysis of Arkansas All-Payers Claims Database.Clinical breast cancer · 2024Article
- Investigation of Factors Affecting Adherence to Adjuvant Hormone Therapy in Early-Stage Breast Cancer Patients: A Comprehensive Systematic Review.Journal of breast cancer · 2023Article
- Preventing metastatic recurrence in low-risk ER/PR + breast cancer patients-a retrospective clinical study exploring the evolving challenge of persistence with adjuvant endocrine therapy.Breast cancer research and treatment · 2023Article
- Adherence to Oral Anticancer Medications Among Women With Breast Cancer in Africa: A Scoping Review.JCO global oncology · 2023Article
- Medication delivery factors and adjuvant endocrine therapy adherence in breast cancer.Breast cancer research and treatment · 2023Article
- Patients' Experience of Medication Brand Changes during Hormone Therapy for Breast Cancer-An Interpretative Phenomenological Analysis.Healthcare (Basel, Switzerland) · 2022Article
- Medication Non-Adherence in Rheumatology, Oncology and Cardiology: A Review of the Literature of Risk Factors and Potential Interventions.International journal of environmental research and public health · 2022Review
- Hormonal Therapy Drug Switching, Out-of-Pocket Costs, and Adherence Among Older Women With Breast Cancer.Journal of the National Cancer Institute · 2022Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundNonadherence to hormonal therapy is common and is associated with increased copayment amount. We investigated the change in adherence after the introduction of generic aromatase inhibitors (AIs) in 2010.
methodsUsing deidentified pharmacy and claims data from OptumInsight, we identified women older than 50 years on brand-name AIs (BAIs) and/or generic AIs (GAIs) for early breast cancer between January 1, 2007 and December 31, 2012. Clinical, demographic, and financial variables were evaluated. Adherence was defined as a medication possession ratio (MPR) 80% or greater.
resultsWe identified 5511 women, 2815 (51.1%) on BAI, 1411 (25.6%) on GAI, and 1285 (23.3%) who switched from BAI to GAI. The median 30-day copayment was higher for BAI ($33.3) than for GAI ($9.04). In a multivariable Cox-proportional hazard analysis, women who took GAI were less likely to discontinue therapy (hazard ratio [HR] = 0.69, 95% confidence interval [CI] = 0.57 to 0.84) compared with BAI. Discontinuation was positively associated with a higher monthly copayment of $15 to $30 (HR = 1.21, 95% CI = 1.01 to 1.44) and more than $30 (HR = 1.49, 95% CI = 1.23 to 1.80) compared with less than $15. In a multivariable logistic regression analysis, adherence (medication possession ratio ≥ 80%) was positively associated with GAI use (odds ratio = 1.53, 95% CI = 1.22 to 1.91) compared with BAI and inversely associated with increased monthly copayment. In addition, adherence was associated with a high annual income of more than $100k/year (odds ratio = 1.58, 95% CI = 1.17 to 2.11).
conclusionsHigher prescription copayment amount was associated with nonadherence and discontinuation of AIs. After controlling for copayment, discontinuation was higher and adherence was lower with Brand AIs. Because nonadherence is associated with worse survival, efforts should be directed towards reducing out-of-pocket costs for these life-saving medications.
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