Less than two percent of patients require high-cost specialty pharmacy medications to treat their complex chronic conditions. These expensive medications are greatly influencing the future of drug spend. The infusion therapies required by the specialty patient population are a growing segment of 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 often well aligned to manage patients with complex chronic diseases, hospitals should be deliberate in their approach to caring for these patients. Even if a hospital is equipped to provide comprehensive care, an infusion center can bridge a gap in their continuum of care by allowing patients to be transitioned from inpatient to outpatient faster. Providing care in the outpatient setting, both the patient and the organization control costs.

As the specialty market continues to expand, lacking internal infusion services often means that a hospital is leaving significant revenue on the table. Organizations with an effective specialty pharmacy, and infusion services in place, often benefit from increased revenue. They are also better positioned to provide improved patient care as needed treatments are more accessible.

Complex management

Effective delivery of infusion therapy requires more than simply dispensing treatments. These drugs require specialized expertise, clinical and support services along with specialized facilities and management skills. Infusion drugs often have specific handling, storage and administration requirements, combined with their complexity and high costs.

Specialty pharmacies that administer infusion drugs are responsible for:

• Following the appropriate procedures for the compounding and distribution of sterile infusion drugs
• Performing drug interaction monitoring and identification of potential drug, dose or drug catheter incompatibilities
• Performing comprehensive patient management procedures, including patient assessment and patient education
• Comprehensive care planning that considers specific patient goals, coordination of treatment and communication with all providers
• Ongoing patient monitoring and assessment regarding the patient’s 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
• Collecting clinical outcomes data, patient perception data, trending and analysis of performance measurement data and evaluations of all sentinel events

Site of Care Matters

Hospitals have historically administered infusion services through their outpatient department. While common, this is also the most expensive method for delivering infusions.

When it comes to administering infusion drugs, payors mandate that hospitals establish cost-effective alternative sites of care (ASOCs) to administer those infusion therapies and retain payor reimbursements. To build a viable plan for keeping those patients and their associated reimbursement dollars in the hospital system, it’s important to think critically. We’ve identified essential component parts of an overarching specialty pharmacy infusion strategy that is designed to keep patients and their associated dollars inside the hospital’s system. To learn more and download CPS' white paper , fill out the form below.