Horizon BCBS of New Jersey Launches Oncology Home Infusion Program | AMCP Nexus 2023

Shifting the site of care from hospitals and clinics to home is a well-trodden path these days in managed care as payers look to make treatment more convenient and less costly.

“But historically oncology drugs have not been included,” Timothy O’Shea, Pharm.D., M.S. manager, clinical pharmacy, at Horizon Blue Cross Blue Shield of New Jersey, said in an interview with Managed Healthcare Executive.

At the Academy of Managed Care Pharmacy (AMCP) Nexus 2023 meeting in Orlando, O’Shea described a program that may change that history and start to make home infusion of cancer drugs a common choice. O’Shea shared some of the information he presented at an AMCP Nexus during a Zoom interview with MHE before the meeting.

O’Shea told MHE that he and others at Horizon knew that they couldn’t conduct a program without a provider partner, so the insurer teamed up with RWJBarnabas Health and Rutgers Cancer Institute of New Jersey (CINJ) , a National Cancer Institute Comprehensive Cancer. Qualitas Home Infusion, a subsidiary of RWJBarnabas, delivered the infusion.

So far, more than 160 patients have taken advantage of the program. “We actually couldn’t enroll patients fast enough,” says O’Shea. CINJ increased its staff by the equivalent of two employees. The program started as a pilot but now, O'Shea says, "it is just what we are doing on a day-to-day basis."

A Horizon survey has shown high patient satisfaction scores, according to O’Shea. All the patients receive their first infusion in a facility. Among those who choose to participate in the home infusion program, “we did not see any appreciable degree of patients going from home infusion back to the facility,” O’Shea said.

Horizon and CINJ worked up a relatively short list of drugs that could be infused that has grown to 30 and includes mainstays such as trastuzumab, which is sold under the brand name Herceptin, and bevacizumab, which is sold under the brand name Avastin. Currently, the PD-1 inhibitors, such as Keytruda (pembrolizumab), are not among the drugs infused at home, O’Shea said, because patients being treated with drugs in that class are often on combination therapies and need to be treated or seen in a facility. In such circumstances, O’Shea said, “it really wasn’t a huge efficiency for the patients to get the drug at home.”

But O’Shea said infusing Keytruda is “on our radar” as Horizon officials consider how to expand the program and replicate the program with other providers in Horizon’s market.