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. 2011 Dec 11;1(4):001.04.a04. doi: 10.5600/mmrr.001.04.a04

Exhibit 1. Use of SERM and AI among elderly hormone receptor-positive female breast cancer patients enrolled in a Medicare Part D prescription drug plan, by patient characteristics, May 2006–December 2007.

Characteristic N Percent using drug p-value2
SERM1 AI1 Neither
All 15,542 22 52 26
Part D benefit-related
 Part D low income subsidy
   No 11,848 23 51 27 < 0.001
   Yes 3,694 21 55 24
 Plan type
   MAPD 6,186 23 51 26 0.10
   PDP 9,356 22 52 26
Demographic/health status
 Age at Part D enrollment
   65 - 69 3,673 20 60 20
   70 - 79 7,387 23 54 23 < 0.001
   80 + 4,482 23 41 36
 Race/ethnicity
   White non-Hispanic 12,576 23 50 28
   White Hispanic 1,057 22 59 19 < 0.001
   Black (non-Hisp. & Hisp.) 931 19 60 21
Other/unknown3 978 23 57 20
 Married
   No/unknown3 8,483 22 50 28 < 0.001
   Yes 7,059 23 53 24
 Urban/rural
   Large metro area 9,723 20 54 26
   Metro/urban 4,758 24 49 27 < 0.001
   Less urban/rural 1,061 33 41 27
 Median income4
   < $30K 2,004 25 52 24
   $30K - $49K 6,338 24 48 28 < 0.001
   $50K + / unknown3 7,200 20 55 25
 HCC risk score
   < = 1.00 7,450 23 50 27
   1.01 - 2.00 5,110 23 51 26 < 0.001
   2.01 + 2,982 19 57 24
Cancer-related
 Year of diagnosis
   2003 4,823 27 45 28
   2004 5,320 22 51 27 < 0.001
   2005 5,399 18 58 24
 Stage at diagnosis
   I 9,261 24 44 32
   II 5,022 21 61 18 < 0.001
   III/IV 1,259 14 74 13
Initial surgery/radiation
 Mastectomy 5,667 22 55 23
   BCS + radiation therapy 7,312 23 52 26 < 0.001
   BCS, no radiation5 2,663 22 45 33
1

Beneficiaries receiving both SERM and AI were assigned to the drug with the earliest fill date during the observation period.

2

p-value for difference between patient characteristic and utilization.

3

Number of unknown cases varied from 2 (median income at census tract/ZIP Code level) to 361 (marital status).

4

census tract/ZIP Code level

5

includes unknown radiation therapy status

Notes:

  • SERM = selective estrogen receptor modulator; AI=aromatase inhibitor; BCS=breast conserving surgery; MAPD=Medicare Advantage prescription drug plan; PDP=stand-alone prescription drug plan; HCC=Hierarchical Condition Category.
  • Exhibit includes beneficiaries diagnosed between 2003 and 2005, with at least 12 months of Part D enrollment between May 2006 and December 2007.

Source: SEER-Medicare.