How Specialty Drug Administration in Non-Hospital Settings Can Improve Care, Lower Costs
Why It May Be Time to Rethink Hospitals for Specialty Medication Infusions
Managing chronic conditions can come with enough challenges—accessing the medications you need shouldn’t be one of them.
Unfortunately, however, where these drugs are administered can play a bigger role than you might realize, not only in quality of care but also in costs. For anyone with a long-term illness, those differences can add up in incredible ways, even in the short term.
Here’s a closer look at how and why, with more on:
To explore more on specialty medications and infusions, check out our Guides on How to Get Medical Infusions While Traveling, the Facts on Pediatric Infusions, and How to Support a Loved One with a Chronic Illness.
How Specialty Medications Factor into Rising Healthcare Costs
It's no secret that healthcare costs in the U.S. have been skyrocketing. In fact, by 2027, experts say healthcare spending will hit an all-time high of ~$6 trillion.
While several factors fuel this unfortunate trend, a few of the main culprits are:
Hospital prices
Avoidable hospital emergency room (ER) visits
Specialty medications
With specialty drugs alone:
Today’s patients are paying roughly 14% more than they did in 2013 for the exact same medications. This includes the cost of the drug and the fees to administer it.
Patients are expected to pay about $100 billion more for the same drugs from 2020 to 2025 alone.
Given that specialty medications have traditionally been administered in hospitals, industry leaders are now looking at the efficacy and viability of alternatives, like receiving treatments at independent infusion clinics, like LUX Infusions.
Specialty Drug Costs in vs. Outside of Hospitals
Looking to quantify costs and evaluate differences in care, researchers analyzed insurance claims data and patient outcomes to determine whether hospitals, hospital-run offices, or non-hospital settings:
Provided better or worse quality of care during the administration of medication
Were associated with more or fewer adverse outcomes, like infections
Charged patients more or less for the same specialty medications
After reviewing data for dozens of medications across hundreds of thousands of claims, experts discovered that:
Receiving specialty infusions in a dedicated clinic, instead of a hospital facility, can cut costs from ~33% to 52% per month.
Many patients receiving specialty drug infusions could save anywhere from $16,000 to $37,000 every year by switching to a non-hospital setting.
The costs of administering the top 10 specialty medications make up about 50% of all specialty medical spending. These administration costs could be cut in half by 50% if these drugs were administered in a non-hospital-affiliated clinic.
*All infographics are from the original study by UnitedHealthcare.
| Condition | Hospital ($/mo) | Independent Clinic ($/mo) | Savings Per Year |
|---|---|---|---|
| Multiple Sclerosis | $20,965 | $11,619 | $37,000 |
| Immune Deficiency | $12,180 | $8,281 | $32,000 |
| Inflammatory Bowel Disease | $11,451 | $6,005 | $28,000 |
| Rheumatoid Arthritis | $11,273 | $5,783 | $21,000 |
| Cancer (Chemotherapy) | $12,315 | $6,828 | $16,000 |
The numbers clarify how patients can save tens of thousands of dollars each year simply by choosing an independent clinic, like LUX Infusion, over a hospital setting for specialty drugs and infusion therapies.
How Specialty Infusion Clinics Can Save Patients Money
Why are hospitals and hospital-affiliated offices so much more expensive for the same specialty medications and drug infusions?
It’s because they generally have higher overhead costs and more complex billing structures.
1. Higher overhead costs
Hospitals and hospital-run facilities usually have extensive infrastructure and administration, with larger departments and more red tape. These bigger operations tend to charge higher rates to cover their higher operational costs, regardless of whether the drug is administered in a hospital or a hospital-owned physician practice.
2. Different billing
Hospital settings can have different ways of billing, charging for each professional seen and/or different aspects of care, sometimes, with each provider billing separately. In non-hospital settings, billing structures and processes can be far more streamlined, often with fewer (or minimal) “facility fees” by comparison.
Beyond Cost: Other Benefits of Specialty Drug Infusions Outside of Hospitals
Lower costs and long-term savings are undeniable advantages of receiving specialty medication infusions in clinics and non-hospital settings. They aren’t the only benefits, however.
Researchers have verified several others, including (and not limited to):
Fewer adverse reactions and ER visits: Infused and injected specialty drugs, while generally well-tolerated, may come with some risks, such as acute infusion reactions. These reactions, which can include fever, chills, low blood pressure, or severe allergic responses, occurred at a significantly lower rate in non-hospital settings compared to hospitals, reducing the likelihood of follow-up emergency room visits or hospital admissions.
Reduced risk of infections: Non-hospital settings can significantly reduce exposure to hospital-acquired infections, which can be especially dangerous for immunocompromised patients. In fact, the incidence of infections from infusion treatments was far lower at physician offices, infusion centers, and homes compared to hospital-run settings.
More personalized care: In smaller, dedicated infusion centers or physician offices, patients are more likely to benefit from an individualized, patient-centric approach. Staff in these settings often have more time to monitor each patient closely, contributing to better treatment adherence, improved outcomes, and higher patient satisfaction.
Greater comfort and reduced stress: Hospitals can be overwhelming and stressful, particularly for patients undergoing frequent or long-term treatments. Receiving treatment in a quieter, less clinical environment — like at a luxury infusion clinic or at home — can put patients at ease, improving their overall experience.
More convenience and flexibility: Scheduling treatments in a hospital often comes with long wait times and limited appointment availability. Non-hospital settings generally offer more flexibility, shorter wait times, and a streamlined treatment process, providing more opportunities for fitting care into active lifestyles.
Fewer disruptions: Hospital visits can require significant time off from work and maybe even some extra help from loved ones. Alternative treatment locations, like local specialty infusion clinics, can cut down on commutes and waiting times, minimize disruptions, and free up more time for other important activities.
Ultimately, the latest research supports what many patients and healthcare providers have long recognized — hospitals aren’t always the best place to receive specialty medications, and patients may have better experiences, lower costs, and improved outcomes when specialty drugs are administered at infusion clinics and in other non-hospital settings.
How to Set Up Specialty Medication Treatments Outside of Hospitals
Choosing a treatment provider is an important decision that requires careful consideration.
Along with cost and quality of care, several other factors should be considered to determine the best options for you and/or your loved ones.
If you need more information about any specialty infusions at LUX Infusion, simply contact us.
