IMS 2025: Expanding Outpatient Access to Advanced Immunotherapies and the Critical Role of Pharmacists

Yi Lin, MD, PhD, hematologist and oncologist at Mayo Clinic, continued her conversation with Pharmacy Times® at the 22nd Annual International Myeloma Society (IMS) Meeting and Exposition in Toronto, Canada, discussing the expansion of outpatient access to advanced immunotherapies. She emphasized the need for broader treatment center participation, proper infrastructure, and alignment of billing, coding, and coverage to support patient access. Lin also highlighted opportunities to leverage tools such as telehealth, remote patient monitoring, and artificial intelligence for more risk-adapted management and efficient outpatient scheduling. Additionally, she underscored the critical role of pharmacists in developing guidelines, managing infection risk, and supporting safe patient care throughout bispecific therapy.

Pharmacy Times: Looking forward, what do you see as the biggest opportunities or challenges in expanding outpatient access to these advanced immunotherapies?

Yi Lin, MD, PhD: Think of more and more treatment centers, including broader hematology-oncology practices, not just the tertiary academic centers that started with these treatments. They gain experience and comfort with administrative drive for that, particularly for these bispecific therapies. It’s very important for patient access. After you get more control, it’s about looking at how to adapt the outpatient model for their infrastructure.

It’s very important that billing, coding, and coverage for outpatient also match to ensure these therapies are adequately covered. I think that’s a very important aspect. All of this certainly includes advocacy for this type of care.

The other opportunity to keep an eye on, which we do a lot of work on at Mayo, is to look beyond how we take care of patients today. Right now, we often identify patients with risk coming into treatment, for example, early intervention, or waiting until they have symptoms and then treating the symptoms. Are there opportunities to use tools like remote patient monitoring, telehealth, artificial intelligence, and machine learning modeling to really take that evolving data—complications, vital signs, logs—so even when patients seem normal, there may be patterns predicting which patient might develop cytokine syndrome or other reactions? Can we use that information for more risk-adapted management?

That’s something outpatient clinics already consider. We can be even more efficient in scheduling—who needs to come in, when we see them, and who could be monitored at home.

Pharmacy Times: How can pharmacists contribute to patient education, adherence, and monitoring to optimize outcomes with outpatient bispecific therapy?

Lin: I think pharmacy is definitely a critical part of our team. They play a major role in working with clinical providers to create good guidelines and ensure consistency of practice. This includes things like having a standard operating procedure in place for medications that manage cytokine release syndrome.

They are also very involved in antimicrobials, infection prevention, prolonged cell care, and immunizations. These are very important to maintain, particularly with bispecifics, since infection risk can be ongoing and cumulative even beyond the end of dosing.

Working closely with pharmacists on first-line and alternative antimicrobials, performance, and prophylaxis recommendations is really very important to help patients safely navigate treatment.