Breast cancer is typically treated first withsurgeryand possiblychemotherapyand/orradiation 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 blockertamoxifen(brand name Nolvadex or Soltamox),andaromatase inhibitorssuch 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.
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Hormone Therapy and Risk of Breast Cancer Recurrence
After primary treatment for breast cancer, there is arisk of recurrence, when the cancer is inremission(no detectable cancer) and then comes back.
With estrogen receptor-positive tumors,late recurrencesare more common than with other types of breast cancer.Hormone therapieshave 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.
Anti-estrogen and estrogen-like effects
For premenopausal women
Older, less expensive drug
Blocks estrogen from binding to breast cancer cells
Aromatase InhibitorsAnti-estrogen effectsFor postmenopausal womenHelp reduce risk of cancer recurrenceNewer and more expensiveStop the body from making estrogen
Anti-estrogen effects
For postmenopausal women
Help reduce risk of cancer recurrence
Newer and more expensive
Stop the body from making estrogen
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 andcompare the costsof the medications that are recommended for you.
Thelowest pricesmay have special requirements. Some have coupons that may come and go. Other low prices may be the result of prescription programs that have strict qualifications.
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’sformulary, you have some options:
If you need to work something out with your insurance company, it may be easier to talk in person than over the phone if you have a local office or representative.
Prescription Assistance Programs
If you are still havingdifficulty paying for the prescriptionyour healthcare provider feels is best, there are more options. Some of these include:
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.
Having Breast Cancer Can Have Short- and Long-Term Effects
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.
Frequently Asked QuestionsTypically, some type of hormone therapy is covered, but the specific medication may vary.Each insurance plan has a formulary that lists the specific medications that are covered. Some insurance plans cover medications in different tiers, or levels, of cost.Learn MoreUnderstanding Your Health Plan Drug FormularyHormone therapy slows current cancer cell growth and prevents cancer from coming back after remission.Research studies also show less death from breast cancer in people who take hormone therapy medications.Learn MoreHormone Therapy for Breast CancerEach hormone therapy medication has specific side effects. However, because these medications work on estrogen, they do not directly affect the immune system. Immune system suppression is more frequently a side effect of chemotherapy (cancer-killing) drugs.Learn MoreWhat You Should Know About ChemotherapyThere can be some serious long-term side effects from hormone therapy. Tamoxifen can raise the risk of uterine cancer and blood clots. Aromatase inhibitors more often cause joint or muscle pain. They may even cause bones to weaken and break.Talk to your doctor about the risks and benefits of any medications that are being recommended.
Frequently Asked Questions
Typically, some type of hormone therapy is covered, but the specific medication may vary.Each insurance plan has a formulary that lists the specific medications that are covered. Some insurance plans cover medications in different tiers, or levels, of cost.Learn MoreUnderstanding Your Health Plan Drug Formulary
Typically, some type of hormone therapy is covered, but the specific medication may vary.Each insurance plan has a formulary that lists the specific medications that are covered. Some insurance plans cover medications in different tiers, or levels, of cost.
Learn MoreUnderstanding Your Health Plan Drug Formulary
Hormone therapy slows current cancer cell growth and prevents cancer from coming back after remission.Research studies also show less death from breast cancer in people who take hormone therapy medications.Learn MoreHormone Therapy for Breast Cancer
Hormone therapy slows current cancer cell growth and prevents cancer from coming back after remission.Research studies also show less death from breast cancer in people who take hormone therapy medications.
Learn MoreHormone Therapy for Breast Cancer
Each hormone therapy medication has specific side effects. However, because these medications work on estrogen, they do not directly affect the immune system. Immune system suppression is more frequently a side effect of chemotherapy (cancer-killing) drugs.Learn MoreWhat You Should Know About Chemotherapy
Each hormone therapy medication has specific side effects. However, because these medications work on estrogen, they do not directly affect the immune system. Immune system suppression is more frequently a side effect of chemotherapy (cancer-killing) drugs.
Learn MoreWhat You Should Know About Chemotherapy
There can be some serious long-term side effects from hormone therapy. Tamoxifen can raise the risk of uterine cancer and blood clots. Aromatase inhibitors more often cause joint or muscle pain. They may even cause bones to weaken and break.Talk to your doctor about the risks and benefits of any medications that are being recommended.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Breast cancer hormone receptor status.American Cancer Society.Hormone therapy for breast cancer.National Cancer Institute.Breast cancer treatment (adult) (PDQ®)—health professional version.Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830Visvanathan K, Fabian CJ, Bantug E, et al.Use of endocrine therapy for breast cancer risk reduction: ASCO clinical practice guideline update.J Clin Onocol. 2019;37(33):3152-3165. doi:10.1200/JCO.19.01472Centers for Medicare and Medicaid Services.Information on essential health benefits (EHB) benchmark plans.Early Breast Cancer Trialists’ Collaborative Group.Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials.Lancet. 2015;386(10001):1341-1352. doi:10.1016/S0140-6736(15)61074-1National Cancer Institute.Hormone therapy for breast cancer.MedlinePlus.Hormone therapy for breast cancer.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Cancer Society.Breast cancer hormone receptor status.American Cancer Society.Hormone therapy for breast cancer.National Cancer Institute.Breast cancer treatment (adult) (PDQ®)—health professional version.Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830Visvanathan K, Fabian CJ, Bantug E, et al.Use of endocrine therapy for breast cancer risk reduction: ASCO clinical practice guideline update.J Clin Onocol. 2019;37(33):3152-3165. doi:10.1200/JCO.19.01472Centers for Medicare and Medicaid Services.Information on essential health benefits (EHB) benchmark plans.Early Breast Cancer Trialists’ Collaborative Group.Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials.Lancet. 2015;386(10001):1341-1352. doi:10.1016/S0140-6736(15)61074-1National Cancer Institute.Hormone therapy for breast cancer.MedlinePlus.Hormone therapy for breast cancer.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Cancer Society.Breast cancer hormone receptor status.American Cancer Society.Hormone therapy for breast cancer.National Cancer Institute.Breast cancer treatment (adult) (PDQ®)—health professional version.Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830Visvanathan K, Fabian CJ, Bantug E, et al.Use of endocrine therapy for breast cancer risk reduction: ASCO clinical practice guideline update.J Clin Onocol. 2019;37(33):3152-3165. doi:10.1200/JCO.19.01472Centers for Medicare and Medicaid Services.Information on essential health benefits (EHB) benchmark plans.Early Breast Cancer Trialists’ Collaborative Group.Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials.Lancet. 2015;386(10001):1341-1352. doi:10.1016/S0140-6736(15)61074-1National Cancer Institute.Hormone therapy for breast cancer.MedlinePlus.Hormone therapy for breast cancer.
American Cancer Society.Breast cancer hormone receptor status.
American Cancer Society.Hormone therapy for breast cancer.
National Cancer Institute.Breast cancer treatment (adult) (PDQ®)—health professional version.
Pan H, Gray R, Braybrooke J, et al.20-year risks of breast-cancer recurrence after stopping endocrine therapy at 5 years.N Engl J Med. 2017;377:1836-1846. doi:10.1056/NEJMoa1701830
Visvanathan K, Fabian CJ, Bantug E, et al.Use of endocrine therapy for breast cancer risk reduction: ASCO clinical practice guideline update.J Clin Onocol. 2019;37(33):3152-3165. doi:10.1200/JCO.19.01472
Centers for Medicare and Medicaid Services.Information on essential health benefits (EHB) benchmark plans.
Early Breast Cancer Trialists’ Collaborative Group.Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials.Lancet. 2015;386(10001):1341-1352. doi:10.1016/S0140-6736(15)61074-1
National Cancer Institute.Hormone therapy for breast cancer.
MedlinePlus.Hormone therapy for breast cancer.
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