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Affordable Care Act Will Cover Breast Cancer Prevention Drugs

Published on | Kylie Chin

Last Thursday, the Department of Health and Human Services (HHS) announced the decision to fully cover medications intended to prevent breast cancer for at-risk women. This comes as part of the Affordable Care Act’s preventative care benefits and goes into effect this coming September—leaving insurers a year to make the change.

The new coverage comes based on a recommendation from the U.S. Preventative Services Task Force (USPSTF) late last year—and simply put, the USPSTF decides what becomes a preventative service. The task force, comprised of scholars and physicians selected by the HHS, recommended that certain medications used to reduce the risk of primary breast cancer be added to the list of preventative services. This recommendation is based on research study results that found women at increased risk of breast cancer that were taking preventative drugs such as tamoxifen and raloxifene, can significantly reduce the relative risk for invasive, ER-positive breast cancer. Until last Thursday, tamoxifen and rolaxifene were not considered preventative—now, women who are at higher risk of developing breast cancer are able to take these medications, free of charge.

It is important to note, that prescription drugs for breast cancer prevention aren’t cheap and the costs of those drugs will certainly be apparent in the premiums that consumers pay for coverage.

Spokesman from the American Cancer Society Action Network, Steve Weiss, told the Huffington Post:

“This policy means millions of women at high risk for breast cancer will know they can access proven risk-reducing medications at no cost to them. 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.”


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