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Women at high risk for breast cancer now to receive some drugs free under Affordable Care Act

HHS news release: “Based on a robust review of the evidence, an independent panel of experts known as the United States Preventive Services Task Force – or USPSTF – recently recommended  that clinicians offer to prescribe chemo-preventive medications like tamoxifen or raloxifene for women who are at an increased risk (provided they are also at a low risk for adverse effects of the medication). The American Society of Clinical Oncology has also recommended these medications to certain women who are at a higher risk.  These are risk-reducing medications which have been shown in randomized, controlled trials to significantly reduce the relative risk for certain types of breast cancer in women who are at an increased risk for this disease.  But there have been questions as to whether these medications are considered prevention for the purpose of consumer protections. So today the Department of Health & Human Services (HHS) issued guidance to clarify that under the Affordable Care Act, most health insurance companies and employer plans must cover tamoxifen and raloxifene – like other recommended preventive services - without co-pays or other out of pocket expenses for women at increased risk for breast cancer.  Access to medications like tamoxifen or raloxifene is just one of many ways the Affordable Care Act is helping the fight against cancer. Through the Health Insurance Marketplace, the new health care law is also helping by making health care more affordable and accessible.”

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