by Angela Maas
With numerous hospitals focused on the COVID-19 pandemic and
many areas under stay-at-home mandates, home infusion is more important than
ever. Changes within the industry already have been seen, and the current
situation is likely to result in permanent shifts within the home infusion
space.
"If you can do infusion at home, you need to do it
there," maintains Ashraf Shehata, KPMG national sector leader for
Healthcare & Life Sciences. "This is about controlling infection risk
in the near term, and many home infusion candidates are in a high-risk
category. Longer term, there has been a shift toward delivering care in the
most economical and clinically appropriate setting, largely driven by
payers."
"We have seen an increase in some home infusion utilization
of select therapies in certain markets where patient administration sites of
care are shifting from the acute care or hospital outpatient setting to the
home, related to the pandemic," says Drew Walk, CEO of Soleo Health.
Some plans already have been shifting administration of certain
therapies to patient homes and provider offices, which are more cost-effective
settings than hospitals, points out Elan Rubinstein, Pharm.D., EB Rubinstein
Associates.
"There could be more home infusion, with drugs that pose
low risk of serious adverse events during or immediately after infusion or
where a patient tolerated prior infusions of these drugs with no or minimal
difficulty," says Rubinstein.
Lisa Kennedy, Ph.D., chief economist and managing principal at
Innopiphany LLC, points out that while CMS has changed some policies in support
of home infusion, "not everyone is on board." She notes that the Community
Oncology Alliance "has raised safety concerns about home infusion centered
on a lack of training of those in the community administering treatment at home
versus trained oncology nurses."
"Going forward there will be a lot of candidates for home infusion,
and some customers/patients may like the convenience of getting care at
home," says Shehata. "There might be opportunities for alternative
care models to be introduced here. The ability for nurses to teach patients how
to self-administer the medicines is an important facet to this."
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