Safer Options for Infusion Treatments

Largest Retrospective Chart Study Shows Benefit of Remicade Infusions At Home or Ambulatory Center

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November 14, 2018
Executive Vice President and Chief Medical Officer, CVS Health
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Patients who receive Remicade infusions in alternate care settings – at home or an ambulatory care center rather than a doctor’s office or as an outpatient treatment at a hospital – had a low incidence of infusion reactions, according to research just published by Coram CVS Specialty Home Infusion Services. The study, published in Digestive Diseases and Sciences, is the largest retrospective chart review conducted to-date of patients receiving Remicade infusions in an alternate-care setting. It found only 2 percent of all infusions administered were associated with an infusion reaction and only 7.8 percent of all patients receiving an infusion experienced an infusion reaction over a three year period beginning in January 2014.

The largest retrospective chart study spanning Jan. 2014-Nov. 2016, reviewed 5,581 nursing visit reports for 796 patients
 7.8% per-patient reaction rate  2% per-infusion reaction rate
Previously published reports indicated:
3-3.5% per-patient reaction rate1 19.1% per-infusion reaction rate2

Alternative-Care Sites Benefit Patients and Payors

A majority of Remicade infusions — 57 percent — happen in a physician office and 39 percent as outpatient treatment with only about 4 percent of patients receiving infusions at home.CVS Health Internal Data; analysis of BOB data.

Home infusions can result in savings of between $1,928 and $2,974 over medical settings, per treatment course.

Despite lower costs for at-home treatment, there has been a trend of Remicade infusions moving toward treatment in physician offices — 37 percent in 2015, up from 34.9 percent in 2012.Source: BHI 2012-2015 Commercial book of business. This has driven a 10 percent increase in overall Remicade spend for payors.CVS Health Internal Data; analysis of BOB data.

Physicians are often concerned about severe reactions to infusion therapy when administered at an alternative site and discontinuance of treatment as a result. The study showed that most infusion reactions from at-home treatment are usually mild to moderate in severity, and Coram nurses were able to successfully manage these reactions. A vast majority — 70 percent — of patients who did have a reaction successfully returned to therapy after the issue was resolved.

The research shows that helping patients transition from a hospital, outpatient or physician office setting to at-home or ambulatory center infusion treatments can be beneficial to both patients and payors.

Coram Nurses Provide Infusion Expertise, Support

Coram has more than 35 years of experience providing enteral nutrition care — tube feeding — and infusion services to patients after they are discharged from the hospital, or when such support is needed as part of their overall treatment regimen. Our more than 2,000 clinicians provide care to nearly 200,000 patients annually for a range of complex conditions including immune deficiencies, neurological disorders, digestive diseases and serious infections. Our specially trained, high-acuity nurses conduct 270,000+ nursing visits annually in patients’ homes or at one of Coram’s 72 ambulatory infusion suites.

Want to learn more about the cost-control and patient care benefits of at-home infusion care? Ask Us
November 14, 2018
Executive Vice President and Chief Medical Officer, CVS Health

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*January 2014-nov 2016.

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Image source: Licensed from Getty Images, 2018.