Home Infusion Therapy Gets Patients Out of the Hospital

Author: Eileen Koutnik-Fotopoulos, Staff Writer

Advances in pharmacy are allowing more patients to receive medications in their homes that would previously have been given in a hospital or clinic setting. The service, known as home infusion therapy, gives pharmacists an opportunity to apply their skills and training to help treat patients'medical conditions from the comfort of home.

In 1986, 2 pharmacists founded Vital Care Inc. The Meridian, Miss-based company was started to help fulfill a need for pharmacists who wanted an infusion business, said Johnny Bell, Vital Care company president. All medications are prepared at the pharmacy and delivered to the patient's home. Local home care agencies administer the drugs. Patients, however, can be taught to easily and safely administer their own medications.

The company's local providers are in 19 states. Individuals who receive home treatment include patients with infections that require intravenous (IV) medications, patients with cancer who need chemotherapy, and patients with severe pain who require intraspinal or IV medications.

Pharmacists who purchase a Vital Care franchise fall into 3 categories: pharmacists who want a stand-alone home infusion business; community pharmacists who want to expand the services already offered; or compounding pharmacists who want to add a home infusion component.

Prior to opening a Vital Care franchise, pharmacists have to fulfill certain requirements. Perhaps most important are the construction of a clean room that meets USP <797> guidelines or remodeling of an existing location if necessary, and hiring a marketing individual who will continue to let the community and health care professionals know about the services offered. As part of the franchise, providers attend a 41/2-day home infusion training program that provides the foundation for being a home infusion provider. The ongoing benefits of a franchise operation include complimentary policy and procedure manuals, billing and collections, and marketing and field sales support.

To avoid competition within the company, Vital Care will not allow a franchise to open in a territory that is too close to another franchise. The pharmacy can be operational anywhere from 60 days to 6 months, depending on the location and circumstances, according to David Buck, director of business and franchise relations.

Because Vital Care providers are mainly in rural areas, Bell believes that home infusion therapy is becoming a pharmacy trend. "What is unique about Vital Care is that we have a program that can work with pharmacists in those [rural] areas and provide a level of service not normally available to patients."

Medicare Part D problems and proposed Medicaid cuts may also drive more pharmacists to consider home infusion. "A lot of pharmacists are looking at home infusion as a way to increase profitability on a pharmacy-related business,"added Bell. He noted, however, that it is not a "quick fix."

Independent pharmacist Bill Moore, RPh, of Moore's Pharmacy Vital Care in Sinton, Tex, said he does not regret buying a franchise over 10 years ago. "I needed the expertise of a franchise to get into the infusion business."

Located in a rural area, his pharmacy covers 8 counties, with no infusion service available outside a major metropolitan area. "It's very rewarding, and we've helped a lot of patients. The patients have contact with us and know who we are."

Theresa Morrow, PharmD, a former hospital pharmacist, opened a standalone home infusion business in March 2005. Vital Care of Southwest Virginia, located in Cedar Bluff, Va, serves patients in 4 counties. The pharmacy also has a license to serve 2 counties in West Virginia because of proximity to the border.

Morrow and her business partner, a registered nurse, decided to pursue a home infusion pharmacy after seeing so many patients unable to leave the hospital because they did not have a means to get the necessary medications at home.

She said the policy and procedures manual from Vital Care has been invaluable. "While I had the infusion side from the hospital, it is still a little different from the hospital to the home setting."

Morrow agrees with Bell that home infusion is becoming a trend. "Managed care and different insurance companies are forcing patients out of the hospital faster. The technology has come to where it's easy to teach people at home."