Factors of Therapy Delivery Tied to Adherence in Nonmetastatic Breast Cancer
The method by which adjuvant endocrine therapy is delivered to patients with breast cancer is associated with rate of adherence, according to data being presented by Joan Marie Neuner, MD, MPH, Medical College of Wisconsin, Milwaukee, and colleagues at the virtual 2020 ASCO Annual Meeting.
“Over 50% of breast cancer patients prescribed adjuvant endocrine therapy…are nonadherent during the recommended 5-year course of therapy,” said Dr Neuner et al, who evaluated the impact that factors of medication delivery—eg, mail order, number of pharmacies, and copays—have on adherence in 15,769 commercially insured patients with breast cancer who initiated endocrine therapy.
Using Poisson regression, the investigators estimated nonadherence risk ratios and adjusted for demographics, comorbidities, total medications, primary cancer treatments, and generic artificial intelligence availability.
“To test whether any observed differences were due to self-selection, we also conducted a negative control analysis,” they said.
The majority (43.3%) of patients included in the study were aged 55 to 64 years. Overall, only 16% of patients used mail order pharmacies for endocrine therapy fills, 58.8% only used 1 pharmacy, and 25.2% had co-pays of ≥$20.
According to the primary analysis, patients who used mail order pharmacies, had only 1 pharmacy, and had lower co-pays were more likely to be adherent to therapy then those who did not, had more than 1, or had higher co-pays, respectively.
These findings remained consistent across sensitivity analyses, with no link observed between mail order and copays and the negative control outcome of any pneumonia diagnoses.
“Medication delivery factors are associated with adherence to breast cancer AET. Future work should investigate whether interventions to streamline medication delivery could improve adherence for this population,” Dr Neuner and colleagues concluded.—Hina M. Porcelli
Neuner JM, Winn AN, Pezzin LE, et al. Factors associated with adjuvant endocrine therapy adherence in non-metastatic breast cancer. Presented at: the 2020 ASCO Annual Meeting; May 29-31, 2020. Abstract 533.
