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- Title
The effect of Medicaid expansion on prescriptions for breast cancer hormonal therapy medications.
- Authors
Maclean, Johanna Catherine; Halpern, Michael T.; Hill, Steven C.; Pesko, Michael F.
- Abstract
<bold>Objective: </bold>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.<bold>Data Source/study Setting: </bold>Medicaid State Drug Utilization Database (SDUD) 2011-2018, comprising the universe of outpatient prescription medications covered under the Medicaid program.<bold>Study Design: </bold>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.<bold>Principal Findings: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
UNITED States; HORMONE therapy; CANCER treatment; BREAST cancer; MEDICAID; MEDICAL prescriptions; MEDICAID statistics; MEDICAID law; THERAPEUTIC use of antineoplastic agents; RESEARCH; AGE distribution; RESEARCH methodology; ANTINEOPLASTIC agents; EVALUATION research; MEDICAL cooperation; SEX distribution; COMPARATIVE studies; RESEARCH funding; PATIENT Protection &; Affordable Care Act; BREAST tumors; LEGISLATION; LAW
- Publication
Health Services Research, 2020, Vol 55, Issue 3, p399
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.13289