The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications

Abstract

Objective To quantify the effects of the Affordable Care Act Medicaid expansion on prescriptions for effective breast cancer hormonal therapies (tamoxifen and aromatase inhibitors) among Medicaid enrollees. Data Source/Study Setting Medicaid State Drug Utilization Database (SDUD) 2011‐2018, comprising the universe of outpatient prescription medications covered under the Medicaid program. Study Design Differences‐in‐differences and event‐study linear models compare population rates of tamoxifen and aromatase inhibitor (anastrozole, exemestane, and letrozole) use in expansion and nonexpansion states, controlling for population characteristics, state, and time. Principal Findings Relative to nonexpansion states, Medicaid‐financed hormonal therapy prescriptions increased by 27.2 per 100 000 nonelderly women in a state. This implies a 28.8 percent increase from the pre‐expansion mean of 94.2 per 100 000 nonelderly women in expansion states. The event‐study model reveals no evidence of differential pretrends in expansion and nonexpansion states and suggests use grew to 40 or more prescriptions per 100 000 nonelderly women 3‐5 years postexpansion. Conclusions Medicaid expansion may have had a meaningful impact on the ability of lower‐income women to access effective hormonal therapies used to treat breast cancer.

The effect of cigarette and e‐cigarette taxes on prescriptions for smoking cessation medications

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An overview of real‐world data sources for oncology and considerations for research

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The Utility of Oncology Information Systems for Prognostic Modelling in Head and Neck Cancer

“…High quality HNC research datasets are scarce; therefore, the suitability of utilising routinely collected OIS data for outcomes analysis is warranted. Conversely, real-world oncology data is used extensively for other purposes [ 14 ], including billing and reimbursement for healthcare services [ 15 , 16 ], documentation, assessment, and provision of clinical care and treatment pathways [ 17 ], epidemiology of disease incidence, prevalence, and trends for disease monitoring [ 18 ], clinical trial drug development [ 19 ], and machine learning (clinical decision-making, treatment planning, image segmentation, and image guidance) [ 20 ].…”