Impact of switching to high deductible insurance on initiation and discontinuation of hormonal therapy among patients with early breast cancer.

• DOI: 10.1200/jco.2016.34.15_suppl.552
• Publication Date: 2018-09-06T12:23:45Z
• Authors: Christine Y. Lu; Anita K. Wagner; Fang Zhang; Larissa Nekhlyudov; Dennis Ross-Degnan; James Frank Wharam
• Keywords: Discontinuation; Deductible; Hormonal Therapy

552 Background: High-deductible health plans (HDHPs) requiring substantial out-of-pocket costs for most services might reduce appropriate care. This study examined the impact of modern HDHPs on use adjuvant hormonal therapy, which is a fundamental treatment secondary prevention in patients with breast cancer. Methods: We studied 970 women newly diagnosed early cancer who were insured by employers that mandated transition from low-deductible ( < = $500) to high deductible > $1,000) coverage and 11,155 contemporaneous whose offered only plans. propensity-score matched transitioning coverage. Measures time initiation therapy discontinuation (60-day gap treatment). used survival analysis estimate changes outcomes. Results: Prior HDHP-switch, was similar between HDHP members controls as expected without chemotherapy. Following had higher likelihood (HR 1.21 [0.96, 1.53]) compared among chemotherapy, but 1.05 [0.87, 1.25]) those Among pre-HDHP switch individuals initiated expected. post-HDHP-switch individuals, again risk 0.89 [0.69, 1.16]). Conclusions: In this rigorous, natural experimental large population incident women, we did not detect reductions or these treatments HPHD members. Further studies should examine effects vulnerable subgroups such low income, racial/ethnic minorities, covered subtype requires full drug cost-sharing.