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Cost sharing for breast cancer hormone therapy: How do dual eligible patients’ copayment impact adherence
OBJECTIVE: 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. RESEARCH DESIGN: Propensity Score methodology was adopted to minimize potential selection bias from the nonrandom allocati...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130966/ https://www.ncbi.nlm.nih.gov/pubmed/34003865 http://dx.doi.org/10.1371/journal.pone.0250967 |
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author | Ma, Siyu Shepard, Donald S. Ritter, Grant A. Martell, Robert E. Thomas, Cindy Parks |
author_facet | Ma, Siyu Shepard, Donald S. Ritter, Grant A. Martell, Robert E. Thomas, Cindy Parks |
author_sort | Ma, Siyu |
collection | PubMed |
description | OBJECTIVE: 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. RESEARCH DESIGN: 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. RESULTS: 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. CONCLUSIONS: 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 | Online Article Text |
id | pubmed-8130966 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-81309662021-05-27 Cost sharing for breast cancer hormone therapy: How do dual eligible patients’ copayment impact adherence Ma, Siyu Shepard, Donald S. Ritter, Grant A. Martell, Robert E. Thomas, Cindy Parks PLoS One Research Article OBJECTIVE: 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. RESEARCH DESIGN: 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. RESULTS: 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. CONCLUSIONS: 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. Public Library of Science 2021-05-18 /pmc/articles/PMC8130966/ /pubmed/34003865 http://dx.doi.org/10.1371/journal.pone.0250967 Text en © 2021 Ma et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ma, Siyu Shepard, Donald S. Ritter, Grant A. Martell, Robert E. Thomas, Cindy Parks Cost sharing for breast cancer hormone therapy: How do dual eligible patients’ copayment impact adherence |
title | 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_short | 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 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8130966/ https://www.ncbi.nlm.nih.gov/pubmed/34003865 http://dx.doi.org/10.1371/journal.pone.0250967 |
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