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Feb 27, 2023
Referring patients to infusion centers reduces costs while maintaining quality of care

Even though less than 2% of people in the United States use specialty drugs, these prescriptions account for 51% of total pharmacy spending.

Many specialty drugs must be injected or infused by a health care provider, and the charges can vary widely from one infusion site to the next. Research from industry group AHIP finds that the cost to patients is particularly high when these drugs are administered in a hospital setting. According to AHIP, a single treatment of specialty drugs administered in hospitals cost an average of $7,000 more than the same drugs administered in infusion centers or other alternate sites of care.

“Site-of-care optimization strategies like referring patients to infusion centers for infusion therapy are one of the most proven strategies for reducing costs for patients,” said Marcus Garcia, senior director of payer and strategy relations at Rocky Mountain Cancer Centers (RMCC), which owns and operates 17 cancer infusion centers in Colorado. “But there are some misconceptions from the medical community around the value of infusion centers for both patients and their providers.”

Common provider misconceptions about infusion centers

Many physicians don’t have a full understanding of the capabilities, safety measures, and quality of care provided at alternative sites of care such as cancer infusion centers, Garcia said. At RMCC, for example, the team is composed of doctors, nurses, and other professionals who specialize in medical oncology, hematology, gynecologic oncology, radiation oncology, surgical oncology, and palliative care.

Infusion centers work closely with each patient’s medical care team, providing infusions that follow the prescribing physician’s directions. The prescribing doctor remains involved in the patient’s care, answering questions and receiving updates throughout entire process.

“We work collaboratively with our own staff and with a patient’s referring physician to provide high-quality, evidence-based care,” Garcia said. “Our providers send a summary note at the conclusion of every treatment to the patient’s physician. Additionally, when there are biosimilar equivalent infusion drugs available that the ordering physician may not know of, we contact them to see if they would like us to switch to the lower-cost biosimilar alternative. Our team becomes an extension of the medical care team, not a substitute.”

Benefits of referring patients to infusion centers

The benefits of infusion centers boil down to quality, access, and cost, Garcia said. Infusion centers follow the same regulatory guidelines and safety standards as hospitals. The differences are that hospitals have a lower nurse-to-patient ratio, while infusion centers often have more locations and offer more flexible scheduling.

By choosing a physician-owned infusion site instead of a hospital’s outpatient department, patients see much lower out-of-pocket and overall costs. For example, as part its partnership with RMCC, Cigna Healthcare patients have realized lower costs, along with increased satisfaction due to the level of coordination between the two organizations.