Expanding affordable access to infused medications

Perspective: Connected care | Capability: Pharmacy | By: Carelon

Patients who rely on infused medications know the high costs associated with care administered in a hospital. Shifting this care from hospitals to ambulatory infusion centers or even the patient's home not only helps address financial concerns, but also leads to more consistent treatment intervals and increased patient satisfaction.

In the following, we share CarelonRx’s approach to helping patients who are navigating complex illnesses so they can receive timely and affordable care tailored to their specific needs.


Why are ambulatory infusion centers important?


Infused medications can be expensive and are often provided in a hospital setting, which is one of the most expensive places to receive care. Hospitals typically charge a facility fee for infusions, usually classified as an administration fee. For some patients, this can add up to thousands of dollars a year.

On the other hand, ambulatory infusion centers outside of a hospital don't typically charge a facility fee, resulting in a two to three times lower cost overall, which can lead to a lower out of pocket cost for patients.

In addition to cost savings, transitioning care to an ambulatory infusion site, a physician's office, or a patient's home can result in improved clinical outcomes. For example, because some hospitals don't have the physical space to accommodate patients week in and week out, the patient’s medication intervals may become staggered. In fact, some patients may get so frustrated, they stop going altogether. That’s why access to ambulatory infusion centers and at-home care are so important – they can have a significant positive impact on the patient's care experience.

How can PBMs help improve access to infused medications?

At CarelonRx, we're working to expand access to affordable care in many ways, including bringing new providers and infusion clinics into our network. We also help to educate our members so they are aware of the most cost-efficient, convenient locations to receive their infused medications. Our ultimate goal is to help our members receive the right care, at the right place, at the right time, and at the most affordable price for them.


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