Managed Care - July 2012 - (Page 37)

Is Home Infusion Ready for Prime Time? Advanced therapy management may lead to physician acceptance of additional medications infused at home By Tom Reinke Cross (IBC) in the Philadelphia area says that additional medications, some of them complex, are working their way into home infusion, but that usage is not yet significant. A move to complex medications, particularly for acute conditions, would be a step up for home infusion. Walgreens is trying to demonstrate that taking that step is feasible and that alternate settings, including the home, are a viable alternative to costly hospital outpatient departments and doctors’ offices. The company has implemented an intensive pharmacist-led therapy management program for intravenous immunoglobulin therapy, one of the few high-cost complex medications in home infusion. H ome infusion has been around for over 30 years, but it is a service that has never really taken off. Effective infusion drugs have been developed for acute conditions, but home infusion has been relegated to less glamorous uses such as parenteral nutrition, analgesics, and antibacterials for chronic situations. Part of the problem may be that home infusion is perceived as a service coming from providers that might have inadequate controls and variable quality. “The challenge has been to get the medical community’s acceptance of this as a safe and effective method of care,” says Paul Mastrapa, president of Walgreens Infusion Services. Walgreens claims to be the country’s largest home infusion provider. The company sees potential for home infusion to overcome its narrow role but there are also important hurdles that stand in the way. Emerging growth Walgreens says home infusion is expanding. “Home infusion is targeting a wider range of medications for acute situations like pain management, chemotherapy, and hydration. We also take care of patients awaiting transplantation and those in latestage heart failure,” says Mastrapa. He says his company has been credentialed by Elan Pharmaceuticals to administer Tysabri (natalizumab), which is restricted by an FDA REMS (risk evaluation and mitigation strategy) program. The company also administers Remicade (infliximab), another biologic. Greg Gambescia, who manages the self-injection and infusion therapy programs at Independence Blue Home infusion will not become widespread until physicians feel that the procedure is safe for their patients, says Don Liss, MD, a senior medical director at Independence Blue Cross in eastern Pennsylvania. JULY 2012 / MANAGED CARE 37

Table of Contents for the Digital Edition of Managed Care - July 2012

Managed Care - July 2012
Table of Contents
Editor’s Memo
Letters
Viewpoint
Legislation & Regulation
News & Commentary
Compensation Monitor
The New Closed Formularies
‘Why Nobody Believes the Numbers’
Q&A With Paul E. Terry, PhD
Home Infusion’s Present and Promise
Fixed-Dose Combo Therapies Show Promise
Plan Watch
Formulary Files
Tomorrow’s Medicine
Outlook

Managed Care - July 2012