Community Oncology Alliance Opposes Home Infusion of Cancer Drugs

The Community Oncology Alliance (COA) released a statement on April 9 explaining that it fundamentally opposes home infusion of chemotherapy, cancer immunotherapy, and cancer treatment supportive drugs due to concerns regarding the safety of patients in such an environment.¹

Infusion therapy is a cornerstone of most cancer care and it allows oncology drugs to be administered intravenously rather than orally in the form of pills or liquid.¹ Over time, infusion therapy moved from the inpatient setting to the outpatient setting, with some suggesting that the next step is home infusion, especially during the coronavirus disease 2019 (COVID-19) pandemic.¹

The COA noted in its statement that although some medical specialties and the diseases they treat may safely allow for the infusion of Medicare Part B drugs at home, oncology is not one of them.¹

According to the COA, many of the adverse effects (AEs) caused by cancer treatment can occur rapidly in unpredictable ways, putting patients’ health in danger unless appropriately monitored.¹ For this reason, home infusion should be provided by a licensed oncology nurse who has experience with potential adverse reactions to treatments so that the nurse can recognize and immediately treat them.¹

Furthermore, a patient’s cancer treatments are ever-changing and require regular modifications.¹ Patients need in-person evaluations and re-evaluations with each cycle of treatment to address AEs and determine efficacy.¹

The COA explained that community oncology practices are also taking extreme measures to ensure the safety of their facilities and their providers during the COVID-19 pandemic, so that patients can receive treatment without fear of COVID-19 infection.¹ When possible, oncologists are also using telehealth methods to monitor patients’ health and ensure that the most urgent treatments are delivered as necessary.¹

During the COVID-19 pandemic, the COA stated that individuals administering cancer treatments need to continue to have access to teams of providers, additional drugs, tools or equipment so that they can deal with patients’ potential adverse reactions, which can not only be sudden and severe, but also life-threatening.¹ For this reason, a lack of access to experienced and trained teams during home infusion is a threat to the success of patients’ treatment, outcome, and safety, rendering such a treatment environment entirely nonviable.¹

REFERENCES

• COA’s Position Statement on Home Infusion [news release]. Washington, DC: Community Oncology Alliance; April 9, 2020. communityoncology.org/coas-position-statement-on-home-infusion/. Accessed April 10, 2020.