Common Causes for Non-Adherence to Endocrine Therapy

Dawn Hershman, MD, MS: So non-adherence to endocrine therapy is really common; I think a lot more common than we initially realized from clinical trials. I think [it’s] because people assumed that if somebody was taking a medicine to prevent their cancer from coming back, they would of course be compliant. But medication non-adherence or non-compliance is incredibly common, both in cancer and in non-cancer—hypertension, anti-HIV, antibiotics. It’s very hard for people to take medications for a long period of time, and part of the reason why patients are non-compliant is related to behavioral factors and remembering to take their medication, but also knowing how important the medication is. It’s related to financial factors such as the cost, how much out of pocket cost they have, how many financial resources they have in addition to the cost, their insurance. But most commonly it’s related to side effects, so patients with more side effects are often less likely to be adherent over the course of their therapy.