Pharmacist Expertise Supports Safe, Scalable Expansion of Outpatient Infusion Services

Demand for outpatient infusion centers is on the rise, driven by a shift away from high-cost in-patient settings toward more accessible, cost-effective care.^1,2 This trend is being reinforced by demographic pressures, increasing chronic disease prevalence, a robust specialty drug pipeline, and reimbursement structures that support care delivery outside the hospital.^1,2

The rapid growth of outpatient infusion services has reshaped not only where care is delivered, but also how it is managed, and pharmacists are central to that shift. Historically trusted as experts in the safe and appropriate use of medications, pharmacists have always been integral to infusion care. However, their present-day responsibilities have expanded significantly, positioning them as strategic leaders who influence clinical coordination, operational efficiency, and financial performance. Examining these diverse roles highlights the critical value pharmacists bring to modern outpatient infusion centers in ensuring safe, sustainable, and patient‑centered infusion care.

Pharmacists Take the Lead in Outpatient Infusion Oversight

Pharmacists’ responsibilities in outpatient infusion services now extend far beyond medication management, encompassing comprehensive oversight of the patient experience. Positioned at the center of care delivery, pharmacists help drive quality, coordinate multidisciplinary teams, and ensure patient safety while supporting financial sustainability.

In this expanded role, they serve as strategic stewards of the entire infusion process, with responsibility across several critical areas.

• Providing clinical expertise: With advanced training in the appropriate use and administration of medications, including complex infusion therapies, pharmacists are central to medication safety and clinical decision‑making. They serve as trusted partners to the care team, guiding dosing decisions and specialty medication referrals as the expanding biosimilar market makes the pharmacist’s role in outpatient infusion settings increasingly vital. With 82 biosimilars approved by the FDA as of early 2026, these cost‑effective therapies are now essential to modern medicine, with growing use across oncology, immunology, and ophthalmology.^3,⁴ However, despite extensive global safety data, biosimilar misconceptions remain common.⁵ Pharmacists help close this gap by educating providers and patients on safety, equivalency, FDA rigor, and payer requirements.
• Coordinating outpatient infusion services: From sourcing and preparation to administration and patient monitoring, pharmacists serve as the clinical coordinators of outpatient infusion services, overseeing the full medication‑use process. Working closely with the care team, they help manage dosing, indications, and adverse effects while ensuring appropriate safeguards and specialized monitoring are in place to support safe, high‑quality care.
• Providing business and economic guidance: Pharmacists bring a rare blend of clinical expertise and business insight to outpatient infusion services, helping practices balance patient care with financial sustainability. By evaluating drug acquisition costs, payer reimbursement, and billing complexity, they support economically viable infusion models while guiding complex prior authorization processes. This integrated perspective enables pharmacists to help operational leaders assess whether infusion services align with patient demand, payer mix, and operational capabilities—supporting data-driven decisions that promote safe, efficient, and sustainable growth.
• Implementing and overseeing technologies: Pharmacists play a central role in implementing and overseeing infusion-related technologies, including drug interaction monitoring and infusion rate alerts within electronic health records. From technology selection to ongoing optimization of infusion devices and drug libraries, pharmacists provide critical oversight, ensuring technology supports, rather than replaces, the clinical judgment essential to accountability and patient safety.

Diversifying the Infusion Portfolio Beyond Cancer

An estimated 133 million Americans live with a chronic disease, and more than 40% require ongoing, specialized infusion care.¹ This growing demand is prompting many oncology infusion centers to expand beyond cancer care, with referrals increasingly coming from rheumatology, gastroenterology, and neurology specialists.

Rheumatologists treat numerous autoimmune conditions that frequently require infusions, such as rheumatoid arthritis, lupus, psoriatic arthritis, ankylosing spondylitis, vasculitis, and gout, and the number of biologic therapies available for these diseases is rapidly expanding.^6,7 Rather than absorbing the cost and operational burden of building in‑house infusion suites, rheumatologists may choose to outsource therapies such as infliximab (Remicade; Johnson & Johnson) and rituximab (Rituxan; Genentech, Biogen) to community oncology centers. These practices are viewed as trusted partners, offering convenient access, well‑equipped facilities, and experienced teams capable of managing the administration, monitoring, and side‑effect profiles of complex infusion therapies.

Oncology practices are also seeing rising referrals from gastroenterologists treating patients with ulcerative colitis, Crohn disease, inflammatory bowel disease, and other autoimmune disorders requiring biologic therapies such as vedolizumab (Entyvio; Takeda). Newer agents such as ustekinumab (Stelara; Johnson & Johnson) and guselkumab (Tremfya; Johnson & Johnson) are now frequently used in this patient population as well and are a growing part of the referral pathway. Neurology referrals are increasing also, particularly for multiple sclerosis treatments such as ocrelizumab (Ocrevus; Genentech), further broadening the scope of outpatient infusion services.

As ambulatory infusion centers continue to expand nationwide to meet non-oncologic demand, oncology practices must adapt quickly to remain competitive. However, successful diversification requires more than speed alone. Careful evaluation of treatment frequency, reimbursement, staffing, and operational readiness is essential to ensure financial sustainability. Pharmacists play a critical role in assessing the feasibility of these investments, helping practices expand thoughtfully and strategically.

Tailoring Outpatient Infusion Services to Meet Community Needs

Meeting community needs requires more than capacity—it requires insight. As demand for outpatient infusion services expands beyond oncology, practices must thoughtfully align growth with local patient needs, operational readiness, and long‑term sustainability.

Outpatient infusion centers have a responsibility to understand their communities by analyzing local demographics and patient populations to identify care gaps and determine which services will have the greatest impact. When specialized infusion care is not available close to home, patients may be forced to travel long distances, undermining the goal of accessible, patient‑centered, community‑based care.

Pharmacists play a pivotal role in addressing these challenges. By bringing together clinical expertise with financial and operational insight, they help practices expand infusion services responsibly and with confidence. Through this leadership and partnership, pharmacists strengthen access to high‑quality, specialized care—ensuring patients receive the therapies they need closer to home, without compromising safety, quality, or viability.

REFERENCES

1. Ambulatory infusion center market size, share, growth, and industry analysis, by type (hospital, clinic, home health agencies), by application (cancer, chronic disease, others), regional insights and forecast to 2035. Market Growth Reports. Updated December 12, 2025. Accessed May 5, 2026. https://www.marketgrowthreports.com/market-reports/ambulatory-infusion-center-market-102825

2. Ambulatory infusion centers market size to exceed US $52.3 billion by 2035 | demand for cost-effective outpatient infusion therapies drives growth – report by TMR. News release. Transparency Market Research. February 24, 2025. Accessed May 5, 2026. https://finance.yahoo.com/news/ambulatory-infusion-centers-market-size-141800390.html?guccounter=1

3. What biosimilars have been approved in the United States? Drugs.com. Updated May 5, 2026. Accessed May 5, 2026. https://www.drugs.com/medical-answers/many-biosimilars-approved-united-states-3463281/

4. McGovern G. Year in review: FDA expands biosimilar approvals across oncology, immunology, and bone health. Pharmacy Times. December 24, 2025. Accessed May 5, 2026. https://www.pharmacytimes.com/view/year-in-review-fda-expands-biosimilar-approvals-across-oncology-immunology-and-bone-health

5. Fero A. Correct patient misconceptions around biosimilars. Pharmacy Times. June 27, 2025. Accessed May 5, 2026. https://www.pharmacytimes.com/view/correct-patient-misconceptions-around-biosimilars

6. What is a rheumatologist and what conditions do they treat? Hospital for Special Surgery. Updated April 24, 2023. Accessed May 5, 2026. https://www.hss.edu/health-library/conditions-and-treatments/what-is-a-rheumatologist

7. Rosman Z, Shoenfeld Y, Zandman-Goddard G. Biologic therapy for autoimmune diseases: an update. BMC Med. 2013;11:88. doi:10.1186/1741-7015-11-88