Alternate Settings for Infusions in Inflammatory Bowel Disease Patients: Homing in on Optimal Care

Excerpt

The US Food and Drug Administration’s approval of the tumor necrosis factor (TNF) antibody, infliximab, in 1998 revolutionized the treatment of inflammatory bowel disease (IBD). The introduction of multiple other biologic therapies for IBD over time and treatment strategies aimed at improving mucosal healing and quality-of-life outcomes has increased the proportion of IBD patients receiving these therapies, which in turn has favorably altered the natural history of the disease, with infusion therapy with infliximab and other biologics becoming a mainstay of IBD therapy. TNF antibodies such as infliximab are implicated in the 72.2% 3-year compounded increase in the US annual expenditures for therapies for inflammatory conditions [1]. Non-drug costs comprise a substantial portion of the total cost of outpatient hospital-based infliximab administration with IBD [2]. Alternate care settings (ACSs) were developed in an effort to reduce costs and increase patient convenience. Currently, the ACS infusion market is estimated to represent approximately $9–11 billion/year in US healthcare expenditures, serviced by over 1500 infusion pharmacy locations, a substantial portion of the infusion market [3]. Yet, little is known regarding the impact of ACS infusions on patients and healthcare costs. …