Building Confidence in Community Bispecific Use Through Standardization

Tara M. Graff, DO, highlighted how targeted education can meaningfully improve clinician preparedness for outpatient monitoring, while underscoring the need for standardized tools and sustainable reimbursement models for bispecific antibodies in community oncology. The discussion stemmed from research from ASH 2025.

Findings showed that after education, clinicians felt more confident managing outpatient bispecific therapy, particularly around monitoring for cytokine release syndrome and immune effector cell–associated neurotoxicity syndrome. Graff emphasized that community practices need detailed standard operating procedures that define team roles, monitoring schedules, and management steps down to the finest details. Checklists, tables, and toxicity management algorithms help ensure consistency and prevent uncertainty during high-risk periods such as step-up dosing.

The data for these tools, Graff noted, must be reflected in consensus guidelines. A standardized approach reduces variability across clinicians and sites, allowing teams to respond quickly and confidently rather than improvising in the moment. As practices treat more patients and gain experience, these processes become more intuitive, further lowering barriers to outpatient delivery.

Despite operational progress, broader system-level challenges remain. Reimbursement for bispecifics varies depending on whether treatment is delivered on a clinical trial or commercially and differs substantially by payer and geography. For independent community practices, inadequate reimbursement can be a major deterrent, particularly given the increased staffing time required for frequent visits, after-hours availability, and toxicity management. Without sufficient financial support, practices risk absorbing losses that threaten sustainability.

Graff stressed that addressing these barriers will require collaboration among pharmaceutical companies, payers, and providers. Improved contract negotiations and payer support mechanisms are essential to ensure that community practices can safely deliver bispecific therapies without compromising their financial viability, ultimately expanding patient access to these transformative treatments.