"Check your coverage NOW"
After surgery, women diagnosed with hormone-receptor-positive breast cancer usually take hormonal therapy medicine to reduce the risk of the cancer coming back (recurrence). Hormonal therapy medicines work in two ways: 1) by lowering the amount of estrogen in the body, and 2) by blocking the action of estrogen on breast cancer cells.
There are several types of hormonal therapy medicines. Tamoxifen, a selective estrogen receptor modulator (SERM), is one of the most well-known. Tamoxifen can be used to treat both premenopausal and postmenopausal women. In 2005, the aromatase inhibitors: 1) Arimidex (chemical name: anastrozole), 2) Aromasin (chemical name: exemestane), and 3) Femara (chemical name: letrozole)
were shown to be more effective at reducing recurrence risk in postmenopausal women and are now used more often than tamoxifen to treat women who've gone through menopause. Aromatase inhibitors aren't yet used to reduce recurrence risk in premenopausal women, though some studies are investigating this option. Hormonal therapy often is taken for 5 years after surgery. Still, research has shown that taking tamoxifen for 10 years instead of 5 years after surgery reduced the number of recurrences and improved overall survival. Many doctors wonder if the aromatase inhibitors may offer more benefits if taken for longer than 5 years.
Both tamoxifen and aromatase inhibitors can cause side effects. Tamoxifen may cause hot flashes and increase the risk of blood clots and stroke. Aromatase inhibitors may cause muscle and joint aches and pains. Less common but more severe side effects of aromatase inhibitors are heart problems, osteoporosis, and broken bones. Research has shown that about 25% of women who are prescribed hormonal therapy to reduce the risk of recurrence after surgery either don't start taking the medicine or stop taking it early. This is due to a number of reasons, but side effects and cost are two of the most common.
A study has found that women diagnosed with early-stage, hormone-receptor-positive breast cancer with no prescription drug coverage were less likely to start hormonal therapy than women who had insurance coverage for prescription drugs. The study also found that women with a household income of less than $40,000 were less likely to complete a full course of hormonal therapy compared to wealthier women. The research was published in the November 2015 issue of Breast Cancer Research and Treatment. Read the abstract of "Prescription drug coverage: implications for hormonal therapy adherence in women diagnosed with breast cancer."
It's important to know that efforts are underway to have the Affordable Care Act to provide prescription coverage that would guard against undue financial hardship in the case that expensive medicines become necessary. It's also important to know that all the aromatase inhibitors are available as generic drugs. Tamoxifen also is a generic drug.
A generic drug has the same active ingredients as an original, brand-name drug, as well as the same dosage, risks, and benefits. The only thing that's different is the name. Generic drugs usually cost much less than brand-name drugs. Generic versions of drugs come to the market when the patent has expired on the brand-name drug.
If you've been diagnosed with breast cancer and don't have insurance or are unemployed, paying for treatment may seem overwhelming. Don't panic, and don't skip any treatments or doctor's visits. There are resources available to help you. Someone at your doctor's office may be able to give you a list of organizations that offer financial assistance for breast cancer medicines and care, as well as local organizations that offer financial assistance for your practical needs such as transportation, food, and child care. Many pharmaceutical companies have set up special funds to help pay for the cost of their medicines. Also contact your local Sisters Network chapter. They may have information and contacts that can assist you as well.
SOURCE: Journal of Breast Cancer Research and Treatment, November, 2015. Synopsis and analysis by breastcancer.org/Admended by Sisters Network Chicago Chapter