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THE NEW PATIENT-CENTRICITY

Citation: Estep J, “The New Patient-Centricity”. ONdrugDelivery, Issue 111 (September 2020), pp 30–32.

Jennifer Estep discusses the new pressures put on the healthcare system by the covid-19 pandemic, and how patients and healthcare providers alike are turning to patient-centric solutions to minimise risks and ease burdens. In particular, Ms Estep looks to the role large-volume wearable injectors could play in facing the challenges presented by the “new normal”.

“At the onset of the pandemic, the risks for patients receiving care increased overnight. Locations patients had relied on to receive care, such as hospitals, became high-risk centres where they might acquire covid-19, and healthcare workers formerly devoted to administering routine care were no longer available for non-acute care.”

The term “patient-centric” has taken on new meaning in recent months due to the covid-19 pandemic. For many healthcare-related companies, patient-centric means “a focus on the needs of the patient”. But with pandemic measures in place, patient needs have expanded, and the industry – medical device and pharma companies, healthcare providers, payers and other key stakeholders related to a patient’s care – must adapt to these increased patient needs.

PATIENT EXPOSURE

At the onset of the pandemic, the risks for patients receiving care increased overnight. Locations patients had relied on to receive care, such as hospitals, became high-risk centres where they might acquire covid-19, and healthcare workers formerly devoted to administering routine care were no longer available for non-acute care.1 Therefore, the pandemic situation prompts the question: in the new normal, should the term “patient-centric” now inherently include allowing a patient to have their healthcare needs met from their home without in-person interaction?

Figure 1: The enFuse® On-Body Infusor is a drug delivery device with a unique technology designed for patient self-administration of high-volume drugs from 3–50 mL. The system is designed with novel features to provide comfort, convenience and simplicity for the patient.

Due to covid-19, changes in the healthcare system have occurred in a fraction of the usual time. From the patient perspective, Medicare reports a surge in US telehealth visit numbers – from 13,000 beneficiaries pre-pandemic to nearly 1.7 million beneficiaries in the final week of April 2020.2 In hitherto unseen numbers, patients are turning to technology to enable telehealth visits with healthcare providers, which accommodate these new patient needs by allowing for the remote continuation of care.

The risk of exposure to covid-19 has prompted change from the healthcare provider side as well, including the need to protect patients from exposure at healthcare facilities and prioritise keeping healthcare resources free for acute care. Because of these and other factors, some listed hereafter, large-volume wearable injectors, such as Enable’s enFuse® On-Body Infusor (Figure 1), are likely to be essential elements making this extensive positive shift in healthcare possible, especially on the accelerated timescale mandated by pandemic conditions.

PATIENT BURDEN

Large-volume wearable injector technology may help to reduce patient burden in several ways (Figure 2). For example, large-volume wearable injectors can:

Figure 2: Enable Injections uses human factors to guide the design of the enFuse® platform, with the goal of providing a product aligned with user preferences, and that can be used safely and effectively to self-administer injectable therapies at the time and place of the user’s choosing.

  • Enable patients to receive therapeutics at home. Once a therapeutic has been formulated and approved for subcutaneous administration, a patient may be able to self-administer their prescribed therapeutic via a large-volume wearable injector in their home, whereas they would have previously needed to have their therapeutic administered in a healthcare facility via intravenous administration.
  • Reduce the need for a healthcare worker to administer care. The demand for healthcare workers has increased with covid-19. Large-volume wearable injectors may reduce, or even eliminate, the need for healthcare workers to administer infusions, therefore making them available for urgent covid-19-related care.
  • Reduce patient and healthcare worker exposure. Healthcare workers, patients and caregivers are all exposed when infusions are conducted in person. Even for situations with a home-infusion set up, a healthcare worker typically has to enter a patient’s home and spends hours in close contact with them during the infusion. Large-volume wearable injector technology has the potential to reduce the need for in-person administration, which reduces the exposure for all involved.
  • Reduce the need for patients to leave the home for their healthcare needs. A large-volume wearable injector has the potential to be shipped directly to a patient’s home.
  • Communicate data automatically through digital technology. Telehealth-enabled infusion devices allow a patient’s data to be communicated directly with key stakeholders involved in their care. A large-volume wearable injector with digital communication technology would potentially allow the healthcare provider, and others involved in a patient’s care, to receive updates on the patient’s infusion, as well as reportable metrics which may verify infusion information and patient adherence.
  • Reduce the financial burden of therapy. The needs of a patient also extend to their financial burden. By reducing the need for expensive visits to a healthcare facility for infusion, large-volume wearable injectors have the potential to provide economic benefits for the patient and payer, in addition to the healthcare benefits already discussed.

AN ECONOMIC MODEL

“For a hypothetical payer, with 1,000 patients receiving intravenous treatment for rheumatoid arthritis, the model shows the introduction of a large-volume wearable injector represents cost savings greater than 35%, or around US$2,000 in cost savings per patient per treatment month.”

Enable Injections has worked with experts in healthcare decision modelling to develop an interactive model that can be used to evaluate the budget impact and cost-effectiveness consequences of an at-home wearable injector. The model assumed the ready availability of an at-home wearable injector that enables subcutaneous self-administration of high-volume therapeutics. Specifically, the model was designed to demonstrate the potential economic value of introducing a large-volume wearable injector for patients who previously received intravenous treatment for a selected indication, in this case, rheumatoid arthritis.

The model was based on published peer-reviewed literature to provide a broad, evidenced-based overview, including the clinical, cost and humanistic benefits of non-institutional therapeutic infusion. The literature search identified 878 unique articles, 63 of which were accepted for inclusion in the review and adopted for the model.

The Economic Takeaway

For a hypothetical payer, with 1,000 patients receiving intravenous treatment for rheumatoid arthritis, the model shows the introduction of a large-volume wearable injector represents cost savings greater than 35%, or around US$2,000 (£1,509) in cost savings per patient per treatment month. These savings result from a significant decrease in the costs of infusion services3 from facilities, supplies and labour. Significant cost savings like these would undoubtedly benefit both the patient and payer.

PATIENT-FOCUSED

Figure 3: Using the automatic vial filling system, the user simply inserts the vial into the system, and the vial’s entire contents are automatically transferred with no further user input.

Enable Injections’ goals have always been driven by the needs of patients. The enFuse® user has been front and centre throughout design and development of the technology, with the goal of meeting patients’ wants, needs and preferences. This philosophy is evident in the design of enFuse®; for example, enFuse® is designed for ease of filling via the automatic vial transfer system at the time of use (Figure 3). Clinical feedback has been positive on the enFuse®, which provides validation that it is on track to achieve the aims of supporting superior outcomes, delivering an exceptional patient experience and driving improved healthcare value and economics.

Especially during the covid-19 pandemic, Enable Injections is staying focused on its goals. The “new normal” places renewed focus on the crucial benefits of self-administered at-home care. Enable Injections strives to embrace the new patient-centricity by providing a solution for patients. Now, more than ever, it is imperative that the industry puts the needs, wants and preferences of the patient first and embraces the new patient-centricity.

REFERENCES

  1. “Re-opening Facilities to Provide Non-emergent Non-COVID-19 Healthcare”. Centers for Medicare & Medicaid Services Recommendations, June 2020.
  2. Verma S, “Early Impact of CMS Expansion of Medicare Telehealth During COVID-19”. Health Affairs Blog, July 2020.
  3. Perraudin C et al, “Switching Patients to Home-Based Subcutaneous Immunoglobulin: an Economic Evaluation of an Interprofessional Drug Therapy Management Program”. J Clin Immunol, 2016, Vol 36(5), pp 502–510.

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