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  1. PBMs and other payers are rapidly becoming interested in site of care management as an important tool for controlling specialty drug costs. Can you give us a sense for how home infusion care fits into that broader cost management landscape?

    Home Infusion can be a cornerstone in site of care management for health plans. The cost for providing specialty infusion drugs in the home versus infusing in a hospital outpatient setting is less than half. In most cases, these drugs can be safely administered in the home. With some drugs and in some locations we can also offer the patient the option to come to one of our infusion suites.

Ted Kramm brings three decades of 
experience in the specialty infusion pharmacy world to his role as Senior Vice President for BriovaRx Infusion Services. Ted helped found AxelaCare, now called BriovaRx Infusion Services, and also serves on the Board of Directors for the National Home Infusion Association.


 2.  We know that home infusion therapy is very effective at reducing health care costs. But aren’t there also significant clinical advantages to home infusion care?                     

There is documented evidence that patient conditions improve and their outcomes are also improved when infusion is done in the home. The psychological effects of being in the home setting cannot be overstated. The clinical benefit is especially relevant in patients who are immune-compromised. These patients should not be in a hospital setting with other patients, because that puts them at risk for infection. We know this, because hospital-acquired infections are one of the most frequent complications that require home infusion in the first place. Keeping patients at home and out of the hospital setting is the simplest way to avoid these infections.


3. BriovaRx® Infusion Services as we see it today is largely the result of bringing the company called AxelaCare into the OptumRx family. Since you led AxelaCare through that transition, could you give us your perspective on the advantages of the new, combined companies?

There are many benefits of being part of the new combined entity with OptumRx and BriovaRx. Our increased purchasing power, shared resources, and reduced costs from sharing pharmacy footprints can only lead to greater benefits for both companies.

We’re building on the relationships already in place to create a single culture where all of our sales teams cross sell each other's products. Now BriovaRx Infusion Services can meet the home infusion needs of some of the largest OptumRx customers.

Overall, I think combining forces to create a culture of One BriovaRx has been hugely successful.

4. Home infusion is a fairly complex process. Not only are there nurses directly delivering care, but there is also a substantial specialty pharmacy dimension. After all, the drugs have to come from somewhere. Tell us how BriovaRx Infusion Services adds value across this entire process.

BriovaRx Infusion Services has built a reputation based on making this complex process easier and more streamlined for our patients and referral sources. The number one differentiator we have is our patient-centric focus.

We have a dedicated team of nurses and pharmacists who work with each referral source to ensure the therapies they are prescribing are clinically appropriate. In this way we help ensure that our patients can get effective access to these expensive and complex therapies.

Additionally, BriovaRx Infusion Services (and previously, AxelaCare) have been innovators in the home infusion market. For example, with our CareExchange outcomes tool, for the first time physicians are able to see real-time data on how patients responded to immune globulin therapy.

The CareExchange tool is exciting because it’s allowing us to actually quantify that each patient gets the right drug, at the right dose, and for the right duration of care. Thanks to the success of this program, we will be expanding it to additional therapies and disease states.

5. It seems like the home infusion marketplace is entering a period of significant change – or, maybe it’s already there. What do you see as the key developments coming down the road, whether that’s the structure of the industry, or regulatory issues, or changing technology?

As with all healthcare businesses there are significant pressures on the home infusion industry to reduce costs. The industry as a whole is looking for ways to become more efficient.

Part of this drive for efficiency is building scale through consolidation, not unlike how AxelaCare grew. I expect to see further consolidation in the industry amongst providers with the goal of achieving economies of scale.

I also believe that, we are about to see a change in the number of specialty infusion patients who have until recently found their way into hospital outpatient centers. With the increasing focus on reducing costs, large payers such as UnitedHealth Group will begin to drive these therapies into the home or to dedicated infusion company facilities.

As far as changing technology, there are constant efforts by the pharmaceutical manufacturers to improve the ease of use of their products. This means developing agents that are given less frequently and for shorter durations. As this development continues, home infusion companies will become even more cost-efficient due the reduced number of infusion days.

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