Presentation (CTI)

OBJECTIVES: To evaluate the clinical safety, operational efficiency, and economic impact of decentralizing highly complex treatments—via subcutaneous (SC) formulations, home-based care, and regionalization—within Latin American healthcare systems.
METHODS: A systematic literature review was conducted using major medical databases (e.g., MEDLINE) to identify real-world evidence published between 2010 and 2026. Studies assessing clinical, operational, and economic outcomes of decentralized oncology and rare disease care models in Latin America compared to centralized intravenous (IV) treatments were extracted and synthesized.
RESULTS: Twenty studies across six Latin American countries were included. Decentralized models maintained clinical non-inferiority and effectively prevented nosocomial infections in high-risk cohorts. Home-based care significantly improved treatment adherence, with compliance rates increasing from historical baselines to between 89% and 98%. Operationally, transitioning to SC formulations substantially alleviated hospital saturation, reducing active healthcare professional time by up to 46% and patient chair time by up to 94%. Economically, SC fixed-dose formulations eliminated weight-based IV drug wastage and reduced non-drug consumable costs by up to 62%, generating direct savings exceeding USD 6,000 per patient annually. Despite these benefits, severe systemic barriers persisted: retrospective cohorts revealed that up to 77% of home infusion interruptions were driven by payer supply failures, and spatial analyses showed that over 55% of oncology patients still required extensive inter-municipal travel due to fragmented regionalization.
CONCLUSIONS: Decentralizing treatments via SC formulations and home care is safe, cost-saving, and dramatically improves adherence in Latin America. However, maximizing this value requires healthcare systems to modernize reimbursement models to incentivize outpatient care and resolve fragmented supply chains.