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Dr Saira Jan Details Current, Future Cost Savings From Oncology Therapeutics Home Infusion Program


Saira Jan, PharmD, MS, of Horizon Blue Cross Blue Shield of New Jersey, discussed cost savings that occurred so far from their collaborative pilot program with Rutgers Cancer Institute of New Jersey and RWJ Barnabas Health and also noted those they predict to occur as the program continues.

Saira Jan, PharmD, MS, of Horizon Blue Cross Blue Shield of New Jersey highlighted the cost savings across stakeholder groups caused by their collaborative oncology therapeutics home infusion pilot program with Rutgers Cancer Institute of New Jersey and RWJ Barnabas Health; she also predicted what cost savings would occur in the future as their program continues. Jan went into more depth about this and other aspects of the program during the AMCP Nexus session "Implementation of a Novel Oncology Home Infusion Model" on October 18.

At Horizon Blue Cross Blue Shield of New Jersey, Jan is the vice president and chief pharmacy officer. She is also professor emerita at Rutgers University's Ernest Mario School of Pharmacy.

This transcript has been lightly edited for clarity.


Could you discuss the total savings accomplished through this program?

When we started the program, the biggest focus was not cost savings; the focus was improving quality, improving accessibility, and making sure the patient gets full chemotherapy in their home. Since we were doing it for other therapies, why could we not do this with oncology?

Interestingly, we saw close to $1 million in savings in the initial 50-patient analysis. We have not incorporated in this the savings that the hospital saw by having additional chairs filled for additional infusions. It is still in the works, but you can imagine that home infusions reduced the hospital-related infusion cost, so that was a significant amount.

Robert Wood Johnson Cancer Institute has now made this business as usual. We ended this pilot in December, and, from January this year, it is business as usual; when the members walk in, they offer that as an option if they want to be infused at home.

The cost savings will come, not only by the backfill to the hospital; from the hospital, it's the cost saved through the added number of patients by backfilling the chairs. For a payer, it is the infusion costs at home. We also work with the benefit design to say member cost sharing should not be high when they're getting an at home infusion.

The bigger cost savings would be having the chemotherapy completed in their given time versus dropping because they don't want to go to the hospital, and that total health outcome due to that chemotherapy is something that will have to be measured in the long run, because if you would not complete your course, there are other implications of disease progression or getting more add-on therapies because now the patient is not controlled. Those aspects we have not even looked at at this point, but that's the premises of why home oncology is critical.

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