introduction of GAIs. For the six months after the first GAI, anastrozole entered the market, there was a 3.2% increase in the slope (p,0.001), and for the six months after letrozole and exemestane entered the market, there was an additional 0.8% increase in the slope (p,0.001). Adherence among LIS beneficiaries was 11.0% higher than non-LIS beneficiaries (p,0.001), but the differences in adherence trends between LIS and non-LIS patients were small and statistically insignificant. Conclusions: With the introduction of generic aromatase inhibitors, the decrease in breast cancer patients' adherence attenuated over the course of their treatment. While the successful implementation of Medicare LIS program minimized the outof-pocket costs for financially vulnerable patients, policymakers should be cautious about not to introducing disparities for those who may be low income but ineligible for such program.
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