Dr Amy Laughlin on At-Home Cancer Care Costs, Advancements

Amy Laughlin, MD, MSHP, of Orlando Health, explained the cost differences for patients with cancer when receiving infusions at home versus in clinical settings. She also shared her predictions for at-home infusion advancements and how they will benefit both patients and providers.

At Orlando Health Cancer Institute, Laughlin specializes in breast cancer, cancer genetics, and high-risk care. She also presented on at-home cancer care at The American Journal of Managed Care^®’s Institute for Value-Based Medicine^® event on November 2, 2023, in New York City.

Transcript

How does the cost of at-home infusions compare with the cost of receiving treatment in a clinical setting?

Probably the most striking discrepancy is with Medicare, where there's a separate Part A, Part B that will cover the hospital-based infusions. How the home infusions are covered varies if it's going to bill to Part D with prescription coverage, whether the person has a managed care plan or a supplemental plan, so I think it just introduces a lot of variation because home as a site of care for infusions or injections for cancer, it is not the primary goal of how these policies are written.

There are some examples where a patient has no cost by going to the infusion center and then is taking the brunt of a lot of the cost personally when it goes to the home. Who that is and how is something we try to assess for the patient before even starting their therapy, but I haven't found a clear pattern to predict who is going to have what cost.

Looking ahead, what advancements do you predict will be made for at-home infusions? How might these benefit patients and providers?

I think that if we really want to bring care closer to the patient, then the policies do need to align with it for that exact reason I just mentioned of that unexpected costs and translating that to the patient. So, I could see things like site-neutral payments being the way of the future where regardless of if it's administered at the hospital or in the home that the person infusing, or the entity infusing, would receive the same payment from the payer; this way, everyone can share the savings.

I could also see the home setting being thought about more in how we administer treatments. Maybe it's the stability of the drug, or safety of administration in the home, how we build those safety protocols to ensure that the same quality given in the infusion center is received at the home, as well.