OBJECTIVES : To provide a broad, evidenced-based overview of the peer-reviewed published literature on clinical, cost, and humanistic benefits of non-institutional therapeutic infusion

METHODS : Searches were conducted in PubMed, EMBASE, and MEDLINE in-Process in June 2019 to identify studies evaluating home infusion versus medical-setting infusion evaluating the following outcomes: costs and health-care resource use; efficacy and safety; patient-centered quality of life; and patient preference, real-world outcomes. Two investigators independently screened all studies identified, according to the inclusion and exclusion criteria.

RESULTS : 878 unique articles were identified. Sixty-three were accepted for inclusion in the review. Most studies (19) were conducted in the US. Other studies were conducted in the UK (8), Canada (6), Australia (6), and Italy (6), among others. Nineteen evaluated patients with cancer. Thirty-seven of the included studies reported economic and/or health care resource use of patients receiving infusions at home vs in a hospital or clinic setting. All studies consistently reported a decrease in costs associated with home infusion treatment over in-hospital or in-clinic treatment. Twenty of the included studies evaluated clinical outcomes associated with in-home infusions vs hospital or clinic treatment. All studies reported improved or similar treatment outcomes with in-home treatment compared to hospital/clinic treatment across multiple disease states. Patient preference studies indicated that the majority of patients preferred home-based treatment.

CONCLUSIONS : Studies reporting economic outcomes consistently found a decrease in costs associated with home treatment vs hospital or clinic treatment. These studies were published as early as 1981 up to 2018. The cost savings were identified from both a health care payer perspective and a patient/societal perspective. All studies which reported clinical outcomes reported improved or similar treatment efficacy and safety with in-home treatment compared to hospital/clinic treatment across multiple disease states. Additionally, patient preference studies indicated that the majority of patients preferred home-based treatment to hospital/clinic-based.