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The Changing Landscape of Infusion Therapy for Immunology

Posted by oiinfusion on Mar 15, 2019 3:59:24 PM

Office-based infusion centers have been a part of oncology practices for many years. As new medications become available, there has been increased demand for infusion-delivered therapies in several additional clinical specialties.

The first instance of infusion therapy used in an immunology setting, was in 1952. A child who suffered from recurring pneumococcal infections was treated with subcutaneous infusions of 3.2 g/month ISG. The treatment produced measurable circulating gamma globulin levels and completely eliminated the pneumococcal infections. [1] Shown to be effective for post-exposure prophylaxis of measles and hepatitis A infections as well, ISG became the standard of care for patients with primary antibody deficiencies. [2]

Subcutaneous infusions of immunoglobulin have become a popular mode of delivery in patients with primary immunodeficiency. [3] These advances and treatment changes have significantly expanded the use of infusion therapies by immunologists.

Infusion as a Major Treatment Option for Severe Asthma

The field of immunology cover the treatment of a number of interrelated autoimmune diseases that have simultaneously developed more robust infusion options collectively in the last 10-20 years. One area of focus that has changed dramatically in terms of treatment as a result of introducing infusion, is in cases of severe asthma.

The majority of patients with asthma can be treated effectively with the proper use of rescue and maintenance medications. However, approximately 5-10% of asthma patients fall into a lesser known category labeled “severe refractory asthma”. These patients are characterized by a “lack of asthma control despite adherence to high dose treatment and correct inhalation technique”. [4] For these patients, inhaled corticosteroids, which are anti-inflammatory medication, are not enough to curb their symptoms. Starting in 2003 with the approval of Xolair® (Omalizumab), an entire class of stronger and better medications have been created to help in this very specific sector of asthma patients. 2016 saw the approval of Cinqair® (reslizumab) ad 2017 introduced two more infusion delivered medications for treatment of severe asthma: Nucala® (mepolizumab) and Fasenra® (benralizumab).

In just the last 3 years immunologists have developed several new and different treatment options in their arsenal for addressing severe asthma patients. As the prescription landscape changes from mostly inhalers and steroid regimens [5], to infusion based medication, the infrastructure of the infusion landscape for this specialty should be considered as the rise in patient infusion continues. The referral model of sending patients out for infusion to either a hospital or a third party location results in a ton of extra administrative work, lack of consistent patient care, and a constant battle for reimbursements. [6]

The Switch to Outsourced In-Office Infusion

It’s time to make the switch from a referral based model to bringing infusion treatment in-house. Moving infusion treatment into your office is a better fit for treating patients. The follow up, the care, it’s all under one roof and can be properly managed. However, trying to incorporate infusion on your own is like adding a start-up business to your practice. There is a much better, more fluid, and safer financial option to setting up an in-office infusion center: outsourcing the management. By outsourcing the management piece, you and your staff can focus on what really matters - patient care.

Icon_drip Treatment Benefits [7] 
  • High-quality care in a comfortable and familiar setting
  • Allows for direct monitoring for adverse events and supervision by their physician
  • Allows optimized follow-up care
  • Ability to educate both nurses and patients on the infusion drugs being used
Icon_clipboard Administrative Benefits
  • No time managing prior authorizations
  • No more finding infusion sites for patients
  • No more fighting denials
  • More time to dedicate to new initiatives
Icon_doctor Physician Benefits
  • Increased revenue for your practice
  • Reduced financial risk
  • Reduced clinical liability to the practice
  • Improved patient-physician relationships
Icon_hand Patient Benefits
  • Greater patient compliance
  • Improved patient satisfaction
  • Better patient experience
  • The comfort of their physician nearby

Want to learn more about outsourcing infusion management for your practice?

Schedule a consultation for  in-office infusion managementReferences

[1] https://lymphosign.com/doi/pdf/10.14785/lpsn-2014-0025

[2] Medical Research Council 1969; Schiff 1994

[3] Gardulf et al. 1991

[4] https://www.aaaai.org/global/latest-research-summaries/New-Research-from-JACI-In-Practice/refractory-asthma  

[5] https://www.uspharmacist.com/article/two-new-medications-for-severe-eosinophilic-asthma

[6] https://www.beckershospitalreview.com/hospital-physician-relationships/considerations-for-opening-an-in-office-infusion-center-and-infusion-center-best-practices-infusion-center-procedures-processes-and-pitfalls.html

[7] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3882956/#i1537-2073-13-2-95-b24 

Topics: Immunology, General Infusion Information, In-Office Infusions