Less than two percent of patients require high-cost specialty pharmacy medications to treat complex chronic conditions. These expensive specialty medications are driving the future of drug spend. Infusion therapies to treat this patient population are a growing part of effective specialty pharmacy services. Though hospital based infusion centers can be challenging to establish and manage, an infusion center should be an integral part of any hospital’s specialty pharmacy strategy.
Why infusion therapies are important to hospitals and health systems
Because hospitals are well aligned to manage patients with complex chronic diseases, hospitals should take a systematic approach for caring of these patients. Hospitals are equipped to provide comprehensive care, and infusion centers can bridge the gap in the continuum of care, by transitioning patients from inpatient to outpatient faster. Providing care in the outpatient setting helps control costs for both the patient and the hospital.
As the specialty market continues to expand, hospitals and health systems without specialty pharmacy services, and infusion services as part of that pharmacy strategy, risk leaving significant revenue on the table. Organizations with effective specialty pharmacy and infusion services in place can benefit from increased revenue as well as improved patient care and outcomes.
Common infusion drugs
The most common infusion drug therapies include: antibiotic, antifungal, antiviral, chemotherapy, hydration, pain management and parenteral nutrition. Infusion therapy is used to treat chronic and rare diseases, including cancers, congestive heart failure, Crohn’s Disease, hemophilia, immune deficiencies, multiple sclerosis, rheumatoid arthritis and more.
Delivering infusion therapy requires far more than simply dispensing drugs. Managing those therapies requires specialized expertise, clinical services, support services, and specialized facilities. Infusion drugs often have specific handling, storage, and administration requirements. Due to their complexity and high cost, these specialty infusion drugs must be managed by clinicians with disease protocol and product expertise.
Specialty pharmacies that administer infusion drugs typically provide the following:
- Appropriate procedures for compounding and distributing sterile infusion drugs
- Drug interaction monitoring and identification of potential drug, dose or drug catheter incompatibilities
- Comprehensive patient management procedures that include patient assessment and patient education
- Comprehensive care planning that considers specific patient goals and coordination of treatment and communication with all providers
- Ongoing patient monitoring and assessment regarding response to treatment, drug complications, adverse reactions, and patient compliance
- Lab reviews and consultation with care professionals to adjust medication orders if needed
- Maintenance of physical facilities for storage, preparation, dispensing, and quality control of infusion medications and equipment
- Employee education and competence validation
- Collection of clinical outcomes data, patient perception data, trending and analysis of performance measurement data, and evaluations of all sentinel events
Site of care matters
Historically, hospitals have administered infusion services through the hospital outpatient department, but this is the most expensive method to deliver infusions.
When it comes to administering infusion drugs, payers are mandating that hospitals establish cost-effective alternative sites of care to administer those infusion therapies in order to retain payer reimbursements.
In order to build a viable plan for keeping those patients and their associated reimbursement dollars in the hospital system, it’s important to think outside the antiquated one-size-fits-all box. We’ve identified critical component parts of an overarching specialty pharmacy infusion strategy designed to keep patients and their associated dollars inside the hospital’s own system. To learn more, request our newest white paper by clicking here:
Infusion: An integral part of an Ambulatory Strategy for Specialty Pharmacy
How to keep patient and payer dollars inside the hospital system