Home Infusion Therapy Gets Patients Out of the Hospital

Advances in pharmacy are allowingmore patients toreceive medications in theirhomes that would previously havebeen given in a hospital or clinic setting.The service, known as home infusiontherapy, gives pharmacists anopportunity to apply their skills andtraining to help treat patients'medicalconditions from the comfort of home.

In 1986, 2 pharmacists founded VitalCare Inc. The Meridian, Miss-basedcompany was started to help fulfill aneed for pharmacists who wanted aninfusion business, said Johnny Bell,Vital Care company president. All medicationsare prepared at the pharmacyand delivered to the patient's home.Local home care agencies administerthe drugs. Patients, however, can betaught to easily and safely administertheir own medications.

The company's local providers are in19 states. Individuals who receive hometreatment include patients with infectionsthat require intravenous (IV) medications,patients with cancer who needchemotherapy, and patients with severepain who require intraspinal or IVmedications.

Pharmacists who purchase a VitalCare franchise fall into 3 categories:pharmacists who want a stand-alonehome infusion business; communitypharmacists who want to expand theservices already offered; or compoundingpharmacists who want to add ahome infusion component.

Prior to opening a Vital Care franchise,pharmacists have to fulfill certainrequirements. Perhaps most importantare the construction of a cleanroom that meets USP <797> guidelinesor remodeling of an existing location ifnecessary, and hiring a marketing individualwho will continue to let the communityand health care professionalsknow about the services offered. Aspart of the franchise, providers attenda 4¹/²-day home infusion training programthat provides the foundation forbeing a home infusion provider. Theongoing benefits of a franchise operationinclude complimentary policy andprocedure manuals, billing and collections,and marketing and field salessupport.

To avoid competition within thecompany, Vital Care will not allow afranchise to open in a territory that istoo close to another franchise. Thepharmacy can be operational anywherefrom 60 days to 6 months,depending on the location and circumstances,according to David Buck,director of business and franchise relations.

Because Vital Care providers aremainly in rural areas, Bell believes thathome infusion therapy is becoming apharmacy trend. "What is unique aboutVital Care is that we have a programthat can work with pharmacists inthose [rural] areas and provide a levelof service not normally available topatients."

Medicare Part D problems and proposedMedicaid cuts may also drivemore pharmacists to consider homeinfusion. "A lot of pharmacists are lookingat home infusion as a way toincrease profitability on a pharmacy-relatedbusiness,"added Bell. He noted,however, that it is not a "quick fix."

Independent pharmacist Bill Moore,RPh, of Moore's Pharmacy Vital Care inSinton, Tex, said he does not regretbuying a franchise over 10 years ago. "Ineeded the expertise of a franchise toget into the infusion business."

Located in a rural area, his pharmacycovers 8 counties, with no infusionservice available outside a major metropolitanarea. "It's very rewarding, andwe've helped a lot of patients. Thepatients have contact with us andknow who we are."

Theresa Morrow, PharmD, a formerhospital pharmacist, opened a standalonehome infusion business in March2005. Vital Care of Southwest Virginia,located in Cedar Bluff, Va, serves patientsin 4 counties. The pharmacy alsohas a license to serve 2 counties inWest Virginia because of proximity tothe border.

Morrow and her business partner, aregistered nurse, decided to pursue ahome infusion pharmacy after seeingso many patients unable to leave thehospital because they did not have ameans to get the necessary medicationsat home.

She said the policy and proceduresmanual from Vital Care has beeninvaluable. "While I had the infusionside from the hospital, it is still a littledifferent from the hospital to the homesetting."

Morrow agrees with Bell that homeinfusion is becoming a trend. "Managedcare and different insurance companiesare forcing patients out of thehospital faster. The technology hascome to where it's easy to teach peopleat home."