What Makes Specialty Infusion Pharmacy So Special?

COMPLEX MEDICATION

Specialty infusion also requires expertise in sterile compounding and in the storage and handling of a variety of complex infused and injectable medications. From patients to payers, stakeholders should ensure that their specialty infusion pharmacy providers have the highest level of independent accreditation, such as URAC specialty pharmacy accreditation. This certification ensures safe, high-quality care, and processes that lead to better patient out- comes. Compounding pharmacies should be independently accredited—for example, by the Pharmacy Compounding Accreditation Board, a service of the Accreditation Commission for Health Care—ensuring that they meet and keep pace with the most rigorous stan- dards as determined by the US Pharmacopeial Convention guidelines.

An example of a medication that requires high-level clinical management and support is Blincyto (blinatumomab), an infused immunotherapy for the treatment of relapsed or refractory B-cell precursor acute lymphoblastic leukemia. It requires both precise compounding in a sterile clean room and careful support during treatment. Infusion is started in the hospital for the first 9 days of the first cycle and the first 2 days of the second cycle. For the next 19 days of the first cycle and 26 days of the second cycle, the medication may be infused in the patient’s home. During treatment, the infusion is continuous and, if it is stopped for more than 4 hours at any point, the patient is at risk for hospital readmission. Understandably, many physicians prefer to work with any of the manufactur- er’s limited distribution home infusion providers to ensure high quality of care.

As a limited distribution provider of Blincyto, Option Care creates customized care plans that include working closely with the referring provider to determine the specific set of services each patient requires, clearly establishing responsibilities of various team members (from specialty infusion to cancer specialists) and providing the patient with education and support before they leave the hospital. Option Care staff receive specialized training on managing patients who receive Blincyto, and they take regular refresher courses to keep current with the latest product-specific information. In addition, Option Care reports all adverse events (AEs) to the drug manufacturer, and both teams meet routinely to analyze and discuss any emerging trends. The benefits of this principled partnership are clear, with the ability to collect data at the point of care—such as the percentage of patients completing their ordered Blinctyo treatment cycles—contributing to both clinical and quality management.

CONTROLLING COSTS

The ability to mitigate and manage costs through various means in the extremely expensive world of specialty infusion pharmacy is essential. Customized and comprehensive clinical care leads to good outcomes, which translates into cost savings in a number of ways, including prevention of AEs and readmission to the hospital.

The level of care provided via specialty therapy programs ensure good outcomes, which lower costs. For example, Option Care's nutrition therapy program includes the administration of Gattex (teduglutide) for select patients with short bowel syndrome (SBS) to increase gastrointestinal absorption of nutrients. Close clinical management confirms that the therapy is as effective as possible, helping patients reduce their dependence on parenteral support.

The results of a study presented at the American College of Gastroenterology’s annual scientific meeting in 20156 regarding patients with SBS demonstrated that those who were administered home-infusion services with parenteral support and Gattex in a closely monitored home-care setting tended to have reductions in the number of days per week that infusions were required; some patients had complete independence.

Findings such as these help manufacturers validate successful outcomes and demonstrate the value of these costly therapies in the real world, when the therapies are supported by high-quality clinical care. The care provided by the specialty infusion provider features regular patient assessment, education, and follow-up, which includes routine visits by skilled nurses, patient monitoring by a nutrition team, and patient oral intake guidance offered by dietitians. Also of note are the cost savings due to reduction in need for parenteral nutrition support, an extremely expensive therapy.

Clearly recognizing its value, payers seek to drive patients requiring specialty infusion to low-cost home care rather than hospitals, the setting of highest cost.7 The qualifier here is “high-quality home care,” as demonstrated through accreditation and outcomes. Although payers understand the cost benefits, the savings are for naught if home infusion is not managed by a high-quality provider and leads to a costly infusion-related AE.

The benefits of home infusion of specialty medications are many. Patients prefer receiving care in the comfort of their home. Health systems and health care providers are grateful for the assurance that discharged patients continue to receive comprehensive care that helps increase compliance and prevent hospital readmission. Manufacturers appreciate that costly, complex specialty medications are administered and managed by highly skilled clinicians. Payers know their patients are getting excellent care at the lowest cost.

Specialty infusion pharmacy services are an important component of specialty pharmacy. Whether you are a professional representing a payer, health system, or drug manufacturer, specialty infusion pharmacy services can deliver meaningful value to you and your patients, optimizing access, improving outcomes, and reducing costs. 

References

  1. Express Scripts Lab. Express Scripts 2015 Drug Trend Reporthttps://lab.express-scripts.com/lab/drug-trend-report.
 
  1. Coleman EA, Parry C, Chalmers S, Min S-J. The care transitions intervention: results of a randomized controlled trial. Arch Intern Med. 2006;166:1822-1828.
  2. Naylor MD, Brooten DA, Campbell RL, et al. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. J Am Geriatr Soc. 2004;52:675-684
  3. Kuhlen JGuyer AMorphew TTachdjian R and Banerji AAssessment of home infusion program for treating nonlaryngeal hereditary angioedema attacks. Ann Allergy Asthma Immunol. 2014 May;112(5):471-2. 
  1. Kennedy S, Curry K and Ford D. Implementation and assessment of a hereditary angioedema home infusion program. Poster presented at the National Home Infusion Association Annual Conference and Exposition; 2012 April 23-25; Phoenix, Arizona.
  2. Petruccelli K, Youssef N., LI B, Curry K. Teduglutide treatment in adult patients with short bowel syndrome (SBS): initial clinical experience of management through a specialized infusion pharmacy (SIP) service. Poster session presented at: the American College of Gastrenterology’s (ACG) 80thAnnual Scientific Meeting; 2015 oct. 16-21; Honolulu, HI.
  3. Maas A. Focus on site of care can boost patient outcomes, payer savings. AIS Health. 2014;10(5).


Most Popular

Related Articles

Top news of the week from Specialty Pharmacy Times.
Accreditation helps pharmaceutical manufacturers narrow the potential pharmacies it may include in a specialty network offering.
Each member of the specialty pharmacy care team is an essential component in influencing and ensuring positive outcomes of therapy.
Company Profile >
Industry Guide >
Market News >
Peer Exchange >
Conferences >
Subscribe >
Specialty Times Resources
About Us
Advertise
Careers
Contact Us
Terms & Conditions
Privacy
MJH Associates >
Pharmacy Times
OTCGuide
American Journal of Managed Care
Cure
MD Magazine
ONCLive
Targeted Oncology
Physicians' Education Resource
Pharmacy & Healthcare Communications, LLC
2 Clarke Drive
Suite 100
Cranbury, NJ 08512
P: 609-716-7777
F: 609-716-4747

Copyright Specialty Pharmacy Times 2006-2018
Pharmacy & Healthcare Communications, LLC. All Rights Reserved.
 

$vacMongoViewPlus$