Millions of Senior Women at High
Risk of Breast Cancer May Get Preventive Drugs Free
Estimates are that over 10 million
women in U.S.age 35 to 79 could be eligible for tamoxifen
chemoprevention on the basis of their risk factors; Obamacare
Galewitz, Capsules, Kaiser Health News
12, 2014 - Starting next September, women at increased risk for breast
cancer will be able to get some drugs shown to help prevent the disease
without a co-pay,
the Obama administration said Thursday.
The U.S. Preventive Services Task
Force recommended last September that clinicians give medications such
as tamoxifen or raloxifene to such women to reduce their risk of the
disease. Under the Affordable Care Act, items or services rated A or B
by the independent review board of physicians and academics must be
covered by insurers without a co-pay or deductible.
Insurers are given a year to make the change.
A spokesman for the insurance
industry noted that while helping breast cancer patients get care is “a
top priority for health plans,” prescription drugs are not “free,” and
the costs of those drugs would be reflected in the premiums that all
consumers pay for coverage.
In addition, “we are concerned
about the precedent of expanding the definition of prevention
to now include some treatmentsthat must be covered with no cost-sharing,”
said the spokesman, Robert Zirkelbach of America’s Health Insurance
“Studies show that even modest
cost-sharing can keep patients from taking advantage of proven
preventive tests and therapies. By making prevention more accessible and
affordable, the health care law is helping people stay healthy and avoid
the high costs of treatment after diagnosis.”
study found that about 52,000 women were taking
tamoxifen, yet the researchers wrote “in 2000, there would have been
some 10 million women in the United States 35 to 79 years of age who
were eligible for tamoxifen chemoprevention on the basis of their risk
factors … For 2.4 million of these women, it was believed that the
benefits of taking tamoxifen outweighed the risks.”
Who Are the High Risk Women
U.S. Preventative Services Task Force (USPSTF) decided against
the routine use of tamoxifen or raloxifene drugs in women who are at
average risk for getting breast cancer,
because the risk of side effects outweighs the potential benefit.
They made the strong
recommendation, however, that women with an
estimated 5-year breast cancer risk of 3% or more, and low risk for side
effects, should consider taking tamoxifen or raloxifene.
The women who might fit this "estimated 5-year risk of 3% or more" have
(or have had):
- Older age (above 55)
- A family history of breast or
ovarian cancer before the age of 50
- A personal history of atypical
hyperplasia in a breast biopsy
- Pre-cancer DCIS; (intraductal
carcinoma); LCIS (lobular carcinoma in situ)
- Extremely dense breast tissue on
- Started their periods early
and/or were pregnant late
- Certain benign (not cancerous)
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