CVS-CTCA Pilot Offers In-Home Infusion of Cancer Therapies

As the U.S. surpasses 570,000 deaths from the COVID-19 pandemic, people with cancer continue to unsurprisingly be hesitant to visit a provider office or hospital for treatment. So, Cancer Treatment Centers of America (CTCA) is working with CVS Health to bring therapies into certain patients’ homes, helping keep immunocompromised people safer and allowing them to continue much-needed cancer treatment.

Multiple studies have shown how the pandemic has affected all aspects of cancer care, from screening and diagnostic workups to actual oncology treatments, follow-up services and patient support (SMA 5/18/20, p. 1). “The COVID-19 pandemic created new challenges for immunocompromised patients with cancer looking for ways to safely continue their care while minimizing their exposure to the virus,” explains Sree Chaguturu, M.D., senior vice president at CVS Health and chief medical officer at CVS Caremark. “CTCA is seeing a 50% reduction in infusions, and, while a slight delay in treatments may have been appropriate at the pandemic’s onset, data is now pointing to increased mortality risk with every month of delayed care. There is a critical need for providing in-home therapy where possible to safely treat patients who are immunocompromised.”

To meet that need, CVS and CTCA — a national oncology network of hospitals and outpatient care centers — recently launched a pilot program known as Oncology Clinic at Home to boost access to in-home chemotherapy for patients meeting certain criteria. The offering is one of a growing number of telehealth services offered by CTCA Anywhere, CTCA’s virtual visit technology.

To qualify, patients must:

• Be in good health and demonstrate they can tolerate their therapies in an inpatient setting;
• Be undergoing treatment with certain types of chemotherapies or immunotherapies;
• Live in a state allowing in-home infused cancer treatments;
• Have reliable internet service;
• Own and be comfortable using a laptop, computer, smartphone or tablet; and
• Have in-home infusion covered by their health insurance policy.

CTCA says that the drugs qualified to be in-home administered are for “many of the most common cancers,” including breast, colorectal, head and neck, lung and prostate cancers, as well as some genitourinary cancers. CVS ships the therapies, as well as any equipment needed to administer them and to monitor patients’ progress, directly to patients, who also are given instructions on handling them.

The pilot launched in the Atlanta area only, but there are plans to expand it. CTCA Atlanta “is located in Newnan, Ga., and recently received Magnet designation by the American Nurses Credentialing Center (ANCC), the highest national honor for nursing excellence,” says Chaguturu. “At CTCA Atlanta’s Lung, GI and Breast Cancer Centers, experienced cancer experts and multidisciplinary teams are committed to delivering comprehensive, integrated care, all in one location. With one of the largest patient bases in the CTCA national oncology network and given the unique rural health care needs of the Georgia patient population, CTCA Atlanta made sense as the pilot location.”

CVS provides the service via its Coram specialty infusion services subsidiary. “By combining home infusions performed by chemotherapy-trained nurses with telehealth oversight and a proprietary technology platform (including patient-reported outcomes and remote patient monitoring), we provide consistent connectivity between the CTCA provider and in-home care team,” Chaguturu explains. “This ensures the highest levels of safety.”

Coram provides infusion therapy services to more than 205,000 people annually in both outpatient and home-based settings, he says. The company offers services at more than 90 locations across the U.S., including more than 70 ambulatory infusion suites, and it has the ability to reach 97% of the U.S. population. “Through Coram, CVS is able to meet people wherever they are and change health care to meet their needs,” Chaguturu says. “Given our commitment to offering diversified health services, we foresee more opportunities to deliver home-based care plans for patients being treated for chronic illnesses.”

Coram nurses have training in chemotherapy administration based on Oncology Nursing Society guidelines, “which focus on safety concerns related to environment of care; treatment planning and patient education; ordering, preparing, dispensing and administering chemotherapy; and monitoring for toxicities, adherence and complications following administration,” he tells AIS Health. “In addition to this, Coram nurses receive training from CTCA both in didactic and on-site forums.”

The care providers are compliant with infection protocols and proactive prevention techniques that are aligned with guidance from the Centers for Disease Control and Prevention aimed at minimizing exposure to and community-based transmission of COVID-19. In addition, the company contacts patients before going into their homes “to understand potential COVID-19 infection or exposure and to ensure continued safety for our clinicians and our patients.”

Patient Care Teams Are Available 24/7

“A patient’s care team is available around the clock to answer questions and provide the support patients need,” he says. “Once home, patients will receive in-home Coram nurse visits to administer the therapy, paired with regular telehealth visits and digital therapeutic check-ins with their CTCA clinician, care team, pharmacists and other clinical staff as needed.”

“The pandemic has created added challenges for immunocompromised patients who need cancer care, a major pain point this pilot is aiming to address,” states Chaguturu. “Even in normal times, CTCA understands the challenges many patients endure to receive chemotherapy — whether they live down the street or hundreds of miles from their hospitals. CTCA strives to make chemotherapy infusions and injections as comfortable and convenient as possible — including by giving qualifying patients the option of receiving these treatments at home. The scope of this program will be determined by the demand for at-home oncology services and the success of the pilot in meeting those needs.”

Ultimately, he says, “We’re proud of the way that we have responded and adapted to new demands during this public health crisis. We will continue to look for ways to meet patients where they are, and help them get the care they need, when and where they need it.”

Contact Chaguturu through Maggie Naples at Maggie.Naples@CVSHealth.com.

This story was reprinted from AIS Health’s monthly publication RADAR on Specialty Pharmacy. Visit https://aishealth.com/product/specialty-pharmacy.

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