Home Infusion: Advantages and Disadvantages

In today’s times with rising healthcare costs, ways to reduce costs while maintaining the quality of treatment and care are looked up to. There are multiple health services that can be delivered in the patients’ home, infusion therapy being one of them. Infusion therapy is the treatment process in which the patients receive medication/drugs through needles or catheters in their veins.

If we look at the modern history of medicine, the main reason for hospitalization was intravenous medication. However, advancement in infusion technology along with skilled nursing teams have made home infusion a reality.1 With home infusion, patients can receive long term therapy without making hospital visits.

Home infusion therapy can be used for administration of, among others, antibiotics, antifungals, antivirals, chemotherapy, multiple sclerosis infusions, hemophilia therapies, pain management, palliative care, enteral and parenteral nutrition.

According to the Department of Health and Human Services, the home infusion is one of the fastest-growing sectors of home healthcare. The American Hospital Association estimates that approximately 133 million Americans currently have at least 1 chronic illness. That figure is forecasted to reach 170 million by 2030, with many of those patients requiring medication that needs to be infused or injected, including the growing number of biologics.2 The global home infusion market is likely to reach USD 86.89 billion by the end of 2027.3 The current pandemic of Covid-19 causing people to stay in their homes also contributes to the importance and use of home infusion therapy.

Increase in the geriatric population and their risk for chronic diseases such as cancer, diabetes, and cardiovascular issues are some of the major contributors to home infusion therapy growth. Incidences of hospital-acquired infections will also go down with home infusion, specifically for those who are immune-compromised.

A 2016 systematic review of 13 published home infusion studies revealed equivalent safety of home infusion compared with hospital infusion, with respect to adverse events such as allergic reactions and other side effects. The same study also compared the outcomes of home infusion versus hospital-based therapy and observed that in all cases, the outcomes were at least equivalent. However, in certain instances, the outcomes were better with home infusion, e.g. patients with hemophilia receiving intravenous clotting factor at home showed a 40% reduced likelihood of hospitalization for bleeding complications. This study also noted that patients preferred home therapy owing to better physical and mental wellbeing and lesser impact on personal and family responsibilities. The review also noted that home infusion costs were significantly lower than medical setting infusion costs, with savings between $1,928 and $2,974 per treatment course. Another study published in 2016 by a Dutch group observed a cost-saving of $58 per infusion for Crohn’s disease.1,4,5,6

A barrier for home infusion therapy is that most developing nations lack reimbursement structures and policies for home treatment which ultimately increases the out of the pocket expenditure. Lack of proper medical assistance and limited resources in home settings may also impact the home infusion market.3 However, smart, and sustainable innovations in the medical device spectrum have the potential to strongly improve the growth opportunity for the infusion market.

  4. Home infusion: Safe, clinically effective, patient preferred, and cost saving | Healthcare
  6. Remicade infusions at home an alternative setting of infliximab therapy for patients with Crohn’s disease | European Journal of Gastroenterology & Hepatology