Breast cancer is typically treated first with surgery and possibly chemotherapy and/or radiation therapy. After the primary treatment, many doctors then prescribe hormone therapy. These medications either stop estrogen from reaching the cancer cells, or they reduce the amount of estrogen that a woman’s body makes.
There are two main kinds of hormone therapy drugs: the hormone receptor blocker tamoxifen (brand name Nolvadex or Soltamox), and aromatase inhibitors such as Arimidex (anastrozole), Femara (letrozole), and Aromasin (exemestane).
The cost of hormone therapy can be an important consideration when working with your healthcare provider on a treatment plan. The costs can vary between these kinds of drugs, which may influence your decision.
This article will discuss the differences between tamoxifen and aromatase inhibitor medications, and explain medication assistance programs.
Hormone Therapy and Risk of Breast Cancer Recurrence
After primary treatment for breast cancer, there is a risk of recurrence, when the cancer is in remission (no detectable cancer) and then comes back.
With estrogen receptor-positive tumors, late recurrences are more common than with other types of breast cancer. Hormone therapies have been shown to reduce the risk of recurrence and improve survival rates.
Basically, estrogen is fuel for this type of tumor. Reducing the amount of estrogen in your bloodstream or blocking estrogen receptors can help protect you from growing new tumors, which reduces the risk of your cancer coming back.
While tamoxifen and aromatase inhibitors both prevent recurrence of estrogen-receptor positive breast cancer, they do work in different ways and for different people.
Comparing Costs
Many women are prescribed hormone therapy for five to 10 years, so the cost can be an important consideration. Tamoxifen is the oldest and most prescribed hormone therapy. Therefore, it tends to be one of the cheapest options.
Below are the pre-insurance, U.S. prices for a month’s supply (30 days) of the brand name and generic versions of tamoxifen and aromatase inhibitors. The lowest costs found using coupons or prescription-assistance programs are also listed.
Work with your doctor and compare the costs of the medications that are recommended for you.
Paying for Hormone Therapy
The costs of these medications can vary considerably based on your insurance coverage. In addition, some insurance companies will cover one type of hormone therapy but not another. Check your insurance coverage and discuss your options with your doctor.
If you are having difficulty affording hormone therapy, you have a few options.
Work With Your Healthcare Provider and Insurance Company
Your first step should be to talk to your healthcare provider and ask about generic options. Share your concerns about affording medications with your prescriber.
If the medication your healthcare provider thinks is best is not in your insurance company’s formulary, you have some options:
You may be able to use a similar medication that is covered by insurance. Your healthcare provider may be able to complete a prior authorization request to get the medication covered. You may also be able to file to appeal the decision. Even if you do have private health insurance, look into your eligibility for Medicare Part D or Medicaid.
Prescription Assistance Programs
If you are still having difficulty paying for the prescription your healthcare provider feels is best, there are more options. Some of these include:
Patient assistance programs: Learn more about the different patient prescription assistance programs available, and check with drug manufacturers for further assistance and savings programs. Drug discount programs: You may be eligible for a prescription drug discount card. Samples: Some oncologists are provided samples of aromatase inhibitors. It can’t hurt to ask. Disability: If you are not yet 65 but can qualify for disability, you may be able to get your medication through Medicare. Online pharmacies: You may find more affordable prices at online retailers. Before you buy, learn about how to safely order drugs on the web. State pharmaceutical assistance programs: Many states have discount or assistance programs. Check to see if your state offers coverage. Nonprofit assistance: Ask your healthcare provider or clinic about local organizations that provide assistance with the cost of prescriptions. You can also check with breast cancer advocacy organizations. Keep in mind that different organizations have different goals, which may or may not include helping patients afford treatment.
Keep Careful Records
Keeping careful records is more important than ever. Insurance requirements change often. Proving your own costs may be required for the insurance to cover your drug.
Many costs for cancer treatment are tax deductible, including the out-of-pocket cost of hormone therapy medications. Good record keeping will help you to prove your expenses at tax time.
Summary
People with estrogen-positive breast cancers may benefit from hormone therapy to prevent cancer from returning. Tamoxifen and aromatase inhibitors are two types of medications that may help. They vary in cost and use, so talk with your doctor about what treatment is most appropriate for you. Work together to figure out how to manage the cost of these medications.
A Word From Verywell
Hormone therapy is recommended for a full five to 10 years after the primary treatment of breast cancer, so the cost of tamoxifen or your aromatase inhibitor is an important factor to consider. You rarely need to pay the full retail price of the drug. With some effort exploring your options, you may be able to significantly lower your overall spending on treatment.
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