Pharmacists Play Key Roles Supporting Patients, Physicians in Home Infusion

In an interview with Pharmacy Times at the 2023 Asembia Specialty Pharmacy Summit, Connie Sullivan, president and CEO of the National Home Infusion Association, discussed pharmacists’ roles in home infusion as well as safety concerns that have been raised by some clinicians. Importantly, Sullivan said data show that adverse events in the home infusion environment are no higher than in any other setting.

Q: What role does the pharmacist play in home infusions? What are some challenges pharmacists should be aware of?

Connie Sullivan: Yeah, I'm really glad you asked that question because I think pharmacists work a lot behind the scenes. In most settings, you know, you don't see a lot of pharmacists when you go into a hospital or office setting. And it's kind of similar in home infusion, but it's pharmacists who are kind of running the care behind the scenes. We kind of call the pharmacist the quarterback, if you will, of home infusion. So, they are supporting that patient; they're also supporting the physician. Physicians can sometimes feel a little bit intimidated by home infusion because I feel like, you know, that care is now outside of what they can see and they're not seeing the patient directly during an infusion. So, I think the pharmacist really plays a big role in coordinating with the nurse and making sure the physician does, you know, feel like they're still monitoring the patient the same way—the patient's getting the same level of care as they would in any other health care setting.

Q: Some experts have raised safety concerns with home infusion. How can these be managed or mitigated?

Connie Sullivan: I think that a lot of those concerns come out of a lack of understanding for home infusion and the policies, the protocols, the accreditation standards that we follow. And so typically, if you actually look at the study data, the adverse events in the home are no higher than they are in any other setting. And often, they're actually lower than what's even in the published clinical trial data for an approved medication. You know, so we see lower catheter infection rates in the home than we do in health care systems. So, we feel like actually a home for a lot of patients is maybe the safest place they can be.

Q: What are some of the reimbursement considerations for home infusion?

Connie Sullivan: This has been a bit of a challenge. Home infusion is widely reimbursed by commercial plans, but it does not have a benefit under the Medicare program. So, if you have any payer other than Medicare, you probably have pretty good access to home infusion. But if you're a Medicare patient and you're in traditional Medicare, you don't have a home infusion benefit. You may have some coverage under the drug benefit and Part D, you may qualify for nursing under Part A, but it's a very fragmented process to try to piece that coverage together. But for the most part, if a patient is a Blue Cross or United Healthcare or Cigna, there are well-established reimbursement pathways for those patients.