An explosion of new and innovative biologic drugs has improved the quality of life for patients suffering from a wide array of chronic illnesses.

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The breakthrough treatments for autoimmune conditions such as Crohn’s disease are a blessing for patients, a boon to society, and a benefit for businesses now able to tap into a pool of talented individuals whose illness-related disabilities would have presented severe workplace challenges just a generation ago.

But these transformative treatments come at a high price for employers. Self-insured employers must bear the cost of both higher premiums for expensive medications, and productivity losses for employees who require frequent, offsite drug infusion treatments.

But employee benefit managers — who must make hard choices about the value of adding additional benefits — can now take a proactive approach to helping patients better manage their chronic conditions, without increasing the bottom line of the company’s health care benefits.

What’s more, they can also minimize treatment disruptions and help workers to keep symptoms at bay and stay productive at work.

Until now, most patients who needed infusion treatments would go to a hospital to receive them.

Hospital-based infusion clinics are expensive, inconvenient and downright unpleasant for the patient. Imagine a large, stark, white room with chairs all around the perimeter. No privacy, no room for a friend or family member to help pass the time, and limited parking are just a few of the hassles associated with the typical hospital-based infusion center.

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Some patients do receive infusions in their doctor’s office. But only a small percentage of specialists offer these services, only to their own patients, and only during limited physician office hours.

Infusion drug solutions to benefit both patients and payers

But now, there are emerging alternatives. Companies like Cerner, a $15 billion, 18,000-employee health care technology company, are among the vanguard of companies that are choosing to direct their patients to community-based infusion sites that offer high quality healthcare at a lower price point and in a much more consumer-friendly environment.

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Employees in Cerner’s Kansas City headquarters and their suburban Philadelphia offices have a new benefit that enables them to seek infusion therapy in a freestanding, concierge-like infusion clinic.

These clinics offer free high-speed Wi-Fi to help patients get some work done remotely and offer evening and weekend appointments that make skipping work for treatments unnecessary.

Cerner expects to reduce total absenteeism at their Kansas City-area facilities by approximately 5,000 hours annually.

The relative low cost of freestanding infusion centers also will help reduce Cerner’s spend on specialty pharmacy, which for many large self-insured employers accounts for up to 40 percent of their total pharmacy spend. For payers, the savings are even more pronounced.

Hospital infusion clinics can be as much as four times as expensive as a freestanding clinic — a gulf that led United Healthcare recently to require prior authorization for hospital-based infusions for inflammatory conditions.

Cerner, and other companies, have realized there is an important role to play for employers to improve medication adherence, both to support workers and to protect the company’s bottom line.

Workers who receive their infusions as prescribed are less likely to contribute to absenteeism, or “presenteeism,” where workers are physically at work but aren’t feeling well enough to be truly productive. In addition, patients who need these specialty drugs are often among the biggest contributors to a self-insured company’s health care costs, thanks to the high cost of both the drugs themselves, and the hospital-based infusion clinics where most patients currently receive these infusion treatments.

Take a proactive approach to improve quality of life and the bottom line

 

If your company doesn’t yet have workers taking infusion drugs, it’s likely just a matter of time. Let’s look at Crohn’s disease, for instance.

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There are 700,000 Americans with this debilitating gastrointestinal condition, and most are diagnosed between the ages of 15 and 35.

Indeed, many of the conditions that can be treated with infusion drugs, including lupus, multiple sclerosis and ulcerative colitis, tend to strike people in the prime of their careers, and must be actively managed with medications throughout an individual’s life. Often, infusion drugs are prescribed after other, more convenient treatments have failed. So, medication adherence is crucial to minimize relapses of serious symptoms.

Patients taking infusion treatments are looking for better options to minimize their time in a hospital setting and to better integrate their treatments into their busy lives. Luckily, community-based infusion treatment centers are not only more desirable for patients, but they make a tremendous amount of sense for employers, since they are less expensive and often closer to work or home than the hospital. This helps minimize the amount of paid or unpaid leave workers need to take to head off relapses that could cost even more lost work time.

Many of the decisions that benefits professionals must make are “either/or” scenarios — should we reduce the value of the health plan, or increase the premium? Should we invest in workplace fitness challenges or offer gym membership subsidies?

But a decision to embrace community-based infusion centers allows companies to improve quality of life for workers living with lifelong chronic conditions, reduce specialty drug spend, reduce absenteeism and improve productivity by improving medication adherence.

As workers have more skin in the game in terms of higher copays, deductibles and coinsurance, they are demanding better options for health care delivery, and patients who need infusion treatments are no exception.

The market, in recent years, has seen the rise of community-based oncology centers and dialysis clinics, to help patients living with cancer and kidney disease to keep as much normalcy in their life as possible and diminish their condition’s impact on their time at work, at home with family, or out with friends.

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