The news release includes information about costs. We would have liked a little more context. The release states: “The costs associated with home infusion were also consistently lower than services provided in a health care facility, with savings ranging between $1,928 and $2,974 per course of treatment.” We need to know what percentage of savings that is per course of treatment. If the whole course costs $100,000, then saving $1,928 is a pretty small percentage. If the whole course is $10,000, than a savings of $1,928 looks more substantial. We found the news release skimmed over giving crucial numbers and metrics for benefits. Separate from the cost benefit to home infusion versus hospital or clinic infusion, the release should have given us some numbers for safety. Here is what the release stated (emphasis ours): “The research showed that patients receiving intravenous therapy at home had as good or better clinical outcomes as those patients who received the same therapy in a traditional health care setting. In addition, patients overwhelmingly preferred receiving their infusion therapies at home, reporting fewer disruptions in personal schedules and responsibilities. We need numbers to demonstrate how “as good” the clinical outcomes were. We need numbers to represent “overwhelmingly preferred.” By what percentage did what number of patients demonstrate preference? This is where the release could have taken some quantitative data from the study. The word “harms” does not appear in the news release. During intravenous infusions there are complications that may arise. The release does not mention harm, even to dismiss the probability as rare. The study being reported is a systematic literature review that only considered 13 prior studies. The release does not address the limitations of a literature review or give us the total number of patients represented by the 13 studies. Only 5 of the 13 studies used in the analysis addressed outcomes. One had no comparison group (“However, no adjustment for confounders was performed, and higher OPAT success rates were likely due to purposeful selection of younger, healthier patients for OPAT therapy,” according to the published study). In another study, “IPAT patients were selected from a time period during which OPAT was not available for any patients, minimizing selection bias by the matching fact.” In any case, less than half of the studies looked at outcome data and those that did involved different diseases from different time periods, some had control groups and some did not. We don’t think the evidence is strong enough to suggest outcomes were improved. The bias inherent in CVS employees culling the studies is also concerning. A better description of the review’s search and selection process may have helped allay any concerns about studies being cherry-picked. There is no disease mongering. The release is clear that the study was done by the CVS Health Research Institute. Since this is a news release from a profit-making company that operates directly to sell services under study, we hope the readers quickly understand there is an inherent conflict. This is the equivalent of a Coca Cola study about the benefits of drinking their product. The release explains the alternatives of clinic or hospital infusion compared to home infusion. Home infusion services are widely available. Their reimbursement is not widely available. The release says “clinical outcomes and quality of care have not previously been systematically evaluated.” The release doesn’t rely on any unreasonable or unjustified language. However, we do not think the news release proves the words used in the headline that say “Home Infusion Care Improves Patient Outcomes and Quality of Life While Reducing Overall Costs.” Based on a literature review, which does not randomize people into apples-to-apples comparison, you cannot claim to show better outcomes. The release does not offer any quantified benefits to support medical outcomes and doesn’t provide quantified information about quality of life improvement. The fact that patients prefer home infusion to travel to a clinic is not by itself a proof that their lives have been improved. As we wrote in the benefits section above — we are not given numbers to prove by what amount patients prefer home infusion.
CVS Health Research Institute Study Shows that Home Infusion Care Improves Patient Outcomes and Quality of Life While Reducing Overall Costs