Clinical and economic impact of infliximab one-hour infusion protocol in patients with inflammatory bowel diseases: A multicenter study

Abstract

AIMTo assess the impact of short infliximab (IFX) infusion on hospital resource utilization and costs.METHODSAll inflammatory bowel diseases (IBD) patients who received IFX 1 h infusion from March 2007 to September 2014 in eight centers from Southern Italy were included in the analysis. Demographic, clinical and infusion related data were collected. The potential benefits related to the short infusion protocol were assessed both in terms of time saving and increased infusion unit capacity. In addition, indirect patient-related cost savings were evaluated.RESULTSOne hundred and twenty-five patients were recruited (64 with ulcerative colitis and 61 with Crohn’s disease). Median duration of disease was of 53 mo and mean age of pts at diagnosis was of 34 years (SD: ± 13). Adverse infusion reactions were reported in less than 4% both before and after short infusion. The total number of infusions across the selected centers was of 2501 (30.5% short infusions). In the analyzed cohort, 1143 h were saved (762 in the infusion and 381 in observation phases) through the rapid IFX infusion protocol. This time saving (-15% compared to the standard protocol in infusion phase) represents, from the hospital perspective, an opportunity to optimize infusion unit capacity by allocating the saved time in alternative cost-effective treatments. This is the case of opportunity cost that represents the value of forgone benefit which could be obtained from a resource in its next-best alternative use. Hence, an extra hour of infusion in the case of standard 2-h IFX represents a loss in opportunity to provide other cost effective services. The analysis showed that the short infusion increased the infusion units capacity up to 50% on days when the IFX infusions were scheduled (infusion phase). Furthermore, the analysis showed that the short IFX infusion protocol leads to time savings also in the post-infusion phase (observation) leading to a time saving of 10% on average among the analyzed centers. Finally, the short infusion protocol has been demonstrated to lead to indirect cost savings of €138/patient (average -€17.300 on the whole cohort).CONCLUSIONA short IFX infusion protocol can be considered time and cost saving in comparison to the standard infusion protocol both from the hospital’s perspective, as it contributes to increase infusion units capacity, and the patients’ perspective, as it reduces indirect costs and the impact of treatment on everyday life and work productivity.

Rapid infusion of infliximab biosimilars and the incidence and severity of infusion‐related reactions in patients with inflammatory bowel disease

“…A number of studies have demonstrated that rapid infusions (≤ 60 min) of reference infliximab are not associated with an increased risk of infusion reactions 5–7 . Shorter infusion administration times provide cost‐saving opportunities for centres by increasing the number of available appointments, and may improve patient experience by reducing the amount of time spent at the facility 8 . Increased use of biosimilar infliximab provides potential cost‐savings for institutions as well 9 .…”

“… 5 , 6 , 7 Shorter infusion administration times provide cost‐saving opportunities for centres by increasing the number of available appointments, and may improve patient experience by reducing the amount of time spent at the facility. 8 Increased use of biosimilar infliximab provides potential cost‐savings for institutions as well. 9 The safety of rapid infusions for infliximab biosimilar agents is largely unknown, and further assessment of rapid infliximab biosimilar infusions is needed to determine the safety of this practice.…”

A quality improvement project reduces time spent at an inflammatory bowel disease infusion center with accelerated infliximab infusion protocol

“…[10][11][12] Furthermore, accelerated infliximab infusions have been shown to reduce significantly nursing time, healthcare resources, and increase patient satisfaction. [13][14][15][16] Given the safety and benefits of accelerated infliximab infusion protocol, our IBD center developed a quality improvement (QI) project to shorten the average time spent at the outpatient biologics infusion center. The primary aim of this QI project was to reduce by 40%, both the average infliximab infusion time and the total time spent at the outpatient biologics infusion center.…”

“…Short infusion (over 30–60 min) protocols have been found safe in patients with rheumatoid arthritis and IBD 10–12 . Furthermore, accelerated infliximab infusions have been shown to reduce significantly nursing time, healthcare resources, and increase patient satisfaction 13–16 …”

“… 10 , 11 , 12 Furthermore, accelerated infliximab infusions have been shown to reduce significantly nursing time, healthcare resources, and increase patient satisfaction. 13 , 14 , 15 , 16 …”