ASCO Statement on Home Infusions Raises Safety Concerns

The American Society of Clinical Oncology (ASCO) has released a position statement on Home Infusion of Anticancer Therapy that raises safety and oversight concerns related to home infusion of anticancer therapy and the Centers for Medicare & Medicaid Services (CMS) regulations regarding the practice. 

In response to the COVID-19 public health emergency, CMS has enabled temporary flexibility related to home infusion for Part B cancer drugs. 

“We understand that COVID-19 has resulted in treatment challenges in some cases, and that home infusion services have been utilized as an alternative to treatment in outpatient facilities, but it is still unclear if the benefits outweigh the risks of this approach,”ASCO President Lori J. Pierce, MD, FASTRO, FASCO, said in a statement. “During and beyond this pandemic, patient safety must continue to be the first priority, and the decision to administer anticancer therapy in a home setting should be made only if both the treating physician and patient agree it’s in the patient’s best interest.”

ASCO states that the decision to administer anticancer therapy in a home setting should be made by the treating physician in consultation with the patient, and only after consideration of the availability of necessary precautions to protect medical staff, patients, and caregivers during infusion and disposal. The position statement makes the following six recommendations: 

• Publicly funded independent research should be conducted to evaluate the safety and effectiveness of home infusion of anticancer therapy. 
• CMS should not extend the temporary flexibility related to home infusion for Part B cancer drugs that was approved as part of the agency's response to the public health emergency. 
• CMS should consult closely with oncology experts prior to implementation of its home infusion benefit in 2021, to ensure that it is only used when the treating physician and patient determine that home infusion is the most appropriate setting based on the patient’s need and treatment plan. Quality reporting for home infusion therapy services should require collection of oncology-specific measures to enable the evaluation of safety in anticancer therapy administration. 
• With anticancer therapy, home infusion benefit policies from public and commercial insurance providers should be strictly limited to exceptional circumstances where the benefits of home infusion outweigh the potential risks to patients. 
• Any insurance provider designing a system to deliver pre-prepared antineoplastic drugs to clinical staff should consult with treating oncologists prior to implementation. 
• Home infusion benefit policies from public and commercial insurance providers should require verification that necessary safety protocols and precautions are in place to protect health care personnel, patients, and caregivers.

Read ASCO's news release and position statement.

Posted 7/31/2020