Opinion
Video
Collaborating to Integrate Subcutaneous
Panelists discuss how the rapid adoption of subcutaneous (SubQ) oncology therapies creates challenges around clinical autonomy, infusion center sustainability, patient experience, and reimbursement models, highlighting the need for collaborative education and flexible care strategies to ensure patient-centered, financially viable implementation.
As the adoption of SubQ oncology therapies accelerates, it brings with it unintended consequences that require thoughtful navigation. A key concern is the diminished role of both physician and patient preference in treatment selection. Despite clear benefits in safety and convenience, decisions are often dictated by what payers will approve, shifting clinical autonomy and potentially complicating the care experience. Additionally, infusion centers—already grappling with capacity constraints and staff burnout—face a new challenge: underutilization. If SubQ options become standard, the financial sustainability of these centers may be threatened, especially if reimbursement models don’t evolve in parallel.
Operationalizing SubQ therapies also disrupts patient routines and expectations. Some patients, accustomed to the community and support found in infusion settings, may resist these faster, more isolated injections. The clinical experience changes not only for the patient but also for the care team, with shorter interactions potentially reducing opportunities for symptom monitoring and support. There’s also the issue of revenue models, particularly buy and build, which many practices rely on to support their operations. Transitioning away from traditional infusion may be perceived as a financial threat, making some organizations hesitant to adopt SubQ formulations, even when clinically appropriate.
Ultimately, successful implementation will depend on cross-disciplinary collaboration and education. Everyone—clinicians, pharmacists, nurses, administrators, manufacturers, and payers—must be part of the conversation to align goals and expectations. Physicians need support to discuss new options with patients. Nurses need retraining to manage new workflows and administration techniques. Practices must also anticipate changing reimbursement structures and explore new care delivery models, including the potential for at-home administration. As the field evolves, prioritizing patient-centered care and maintaining flexibility will be essential to navigate the complex shift toward more widespread SubQ use in oncology.
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