Impact of high-deductible insurance on adjuvant hormonal therapy use in breast cancer

Breast Cancer Research and Treatment
Christine Y LuJ Frank Wharam

Abstract

High-deductible health plans (HDHPs) have become the predominant commercial health insurance arrangement in the US. HDHPs require substantial out-of-pocket (OOP) costs for most services but often exempt medications from high cost sharing. We examined effects of HDHPs on OOP costs and utilization of adjuvant hormonal therapy (AHT), which are fundamental care for patients with breast cancer. This controlled quasi-experimental study used claims data (2003-2012) from a large national health insurer. We included 986 women with incident early-stage breast cancer, age 25-64 years, insured by employers that mandated a transition from low-deductible (≤ $500/year) to high-deductible (≥ $1000/year) coverage, and 3479 propensity score-matched controls whose employers offered only low-deductible plans. We examined AHT utilization and OOP costs per person-year before and after the HDHP switch. At baseline, the OOP costs for AHT were $40.41 and $36.55 per person-year among the HDHP and control groups. After the HDHP switch, the OOP costs for AHT were $91.76 and $72.98 per person-year among the HDHP and control groups, respectively. AHT OOP costs increased among HDHP members relative to controls but the change was not significant (relative cha...Continue Reading

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Citations

Nov 30, 2018·Journal of the National Cancer Institute·Ronald M KlinePatricia A Ganz
Dec 18, 2018·Pediatric Blood & Cancer·Susan K Parsons, Anita J Kumar
Jun 23, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Barbara PistilliInes Vaz-Luis

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