Oncology Rounds

Infusion center insights: In-house pharmacy service trends

by Bryan Miller

This is part of a weekly series on results from our 2015 national benchmarking survey on infusion center volumes, staffing, and operations. Make sure you’re subscribed to follow along.

We’ve recently spoken to several cancer programs that are interested in providing in-house pharmacy services, such as a dedicated oncology pharmacy or a retail pharmacy, with the goals of generating revenue and improving patient management. While these services can add value to your program, they’re not for everyone.

To help you better understand the scope of in-house pharmacy services provided by different types of cancer programs, we asked about this in our Infusion Center Survey—keep reading to see what we found.

Patient volume associated with in-house pharmacy services

Organizations with a dedicated oncology pharmacy treat a higher number of patients per day—almost 50% more—than respondents without a dedicated pharmacy.

Similarly, programs that have a retail pharmacy that dispenses oral chemotherapeutics treat a higher number of patients in their infusion center each day compared to those that do not. These findings, combined with those above, suggest that organizations meeting a specific volume threshold are more likely to invest in these services.

Facility type associated with in-house pharmacy services

Sorting by facility type reveals that academic medical centers (AMCs) and teaching hospitals are more likely to have dedicated oncology pharmacies and retail pharmacies than community hospitals.

Despite having relatively low infusion center volumes, every freestanding cancer center that participated in our survey had a dedicated pharmacy, but only one had a retail pharmacy.

Dedicated pharmacy associated with drug turnaround time

To figure out if having a dedicated pharmacy improves drug turnaround time, we asked respondents how long it takes from when the pharmacy is asked to begin mixing a patient’s drugs until the drugs are sent to the infusion center. More than 50% of respondents reported a turnaround time of 30 minutes or less. Programs with a dedicated oncology pharmacy are slightly more likely to meet the 30-minute mark.

Brown bagging and white bagging are not widespread practices

Given the extreme caution that must be exercised when handling cancer drugs, it is not surprising that very few institutions allow brown bagging—when infusion drugs are shipped to the patient from an outside pharmacy. However, white bagging—when infusion drugs are shipped to the cancer center from an outside pharmacy—is allowed by almost 1/3 of our respondents. There was little variability in responses across types of facilities, except for freestanding cancer centers which are more likely to allow white bagging and less likely to allow brown bagging.

Programs with a dedicated oncology pharmacy are less likely to allow white bagging or brown bagging than programs without a dedicated pharmacy.

Also, programs enrolled in the 340B program are less likely to allow white bagging than non-340B programs. This makes sense considering that white bagging eliminates the drug discount received by 340B organizations.


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