Ensuring Successful Integration of Bispecific Antibodies: Operational and Clinical Strategies for Managed Care Organizations and IDNs
An expert discusses the operational and financial complexities of integrating bispecific antibodies into multiple myeloma treatment pathways, emphasizing the need for standardized protocols, multidisciplinary training, payer-provider collaboration, and infrastructure investments to support safe, scalable, and value-based delivery of care.
The integration of bispecific antibodies into treatment pathways introduces considerable operational complexity, including the need for specialized infrastructure, staffing, monitoring protocols, and financial systems. Administering these therapies requires careful management of toxicities such as cytokine release syndrome and neurotoxicity, especially during the initial step-up dosing phase. Many centers still lack the inpatient units or trained outpatient resources to support this need. Institutions are responding by developing standardized protocols, training multidisciplinary teams, and exploring outpatient or even home infusion options to improve feasibility and reduce hospital strain.
From a payer and managed care perspective, these therapies present unique challenges due to their split inpatient/outpatient administration and high monitoring demands. Complex reimbursement workflows, prior authorizations, and patient assistance programs must be streamlined to avoid access delays. Managed care organizations can play a critical role by supporting toxicity management programs, offering flexible coverage models, and incentivizing adherence to published safety guidelines. Investments in telehealth, nurse navigation, and remote monitoring systems are vital to detecting early toxicity and preventing costly hospitalizations. Real-world data collection on toxicity incidence, hospitalization, and outcomes can further drive value-based contracting and continuous quality improvement.
While some progress has been made in preparing for bispecific antibody therapy, significant variation remains across sites in terms of readiness. Many institutions still lack real-time data infrastructure and experience in transitioning patients to outpatient care. To ensure optimal integration, stakeholders must standardize protocols, train staff, enhance care coordination, and invest in technology that supports tracking and analysis. Engagement between payers and providers is essential to develop flexible, clinically aligned coverage policies that address the nuances of bispecific therapy. Additionally, forward-looking resource planning—including budgeting for drug acquisition, supportive care, and staffing—is necessary as these therapies are expected to expand into earlier lines of treatment and reach more patients.
Newsletter
Get the latest industry news, event updates, and more from Managed healthcare Executive.
