Background The use of Infliximab in inflammatory arthritides (IAs) has been extensive with statistically favourable responses in disease activity. Despite proven clinical improvement, biological agents such as Infliximab are costly. Infliximab is given as an intravenous infusion on a monthly basis. To date these infusions have been performed in secondary care.
At present, a home infusion service as part of Healthcare at Home is funded by MSD. This service was extended to the Leicestershire region, as part of a pilot study.
Objectives The aim of this study was to improve cost effectivity of Rheumatological services within Leicestershire, an important exercise at a time of financial crisis within the NHS.
Methods Ten patients with IAs such as rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS) were identified as receiving Infliximab through the University Hospitals of Leicester Rheumatology biologics database and invited to participate in this pilot study.
The nurse administered the Infliximab within the patients' own homes. Length of infusions and visits were analysed and number of vials used recorded. A service satisfaction questionnaire was distributed to each patient.
Results All patient participants were established on Infliximab having had over 8 infusions each. One patient had PsA, 3 had AS and 6 had RA. The median age was 64 years. A total of 42 infusions were administered, 39 of which were given at home and 3 were given in hospital. Thirty of the infusions were successful, yet 12 infusions were not commented upon. There were no adverse reactions and only 1 case incurred wastage due to apparatus issues. Infusions lasted up to 1 hour and longest total visit time was 3 hours and 15 minutes. Cost savings of £5,066.34 per infusion of 10 patients and £32,931.21 per annum were made (Table 1).
Patient satisfaction was analysed via a questionnaire. Of the 9 responses received, the general feedback was that this was a great development and preferred to the hospital setting.
Conclusions Providing Infliximab within patients' homes has proven that an immense cost saving can be made on annual basis thus allowing the funding of other services essential to delivering optimal care to our Rheumatology patients. Furthermore, this service is an attractive option as it abides with NHS policy, providing care closer to home and giving patients greater choice as to how and where they receive their care.
Disclosure of Interest None declared