The ongoing challenges with OPAT.
Outpatient parenteral antimicrobial therapy (OPAT), first introduced in 1977, is a patient management strategy whereby intravenous antibiotics are administered via a long-term intravenous catheter when hospitalization is unnecessary. This is done with the goal of improving the patient experience while reducing healthcare costs. As such, OPAT is a dominant component of home infusion services.
Today, antibiotics account for 132 million OPAT doses
and are expected to see an 8.8% compounded annual
growth rate from 2016 to 20231, 2
OPAT is predominantly administered intravenously via a peripherally inserted central catheter (PICC or PICC line), which must remain in place over several days or weeks. Although effective, this approach requires extensive coordination of care and can result in multiple medical complications including PICC line site infections, bloodstream infections, PICC line occlusions and blood clots, that may require unscheduled ER and medical visits.3, 4, 5
Outpatient infusion services require labor-intensive coordination, professionally trained medical personnel and significant associated resources. Additionally, home infusion of OPAT is not covered for most Medicare patients, so these services can be cost prohibitive and logistically problematic. As a result, Medicare patients that require OPAT are often dependent on infusion centers, clinics, or nursing homes for care.
1 132 million doses calculated based on IMS 2015 and AMR 2017 data sets.
3 Shrestha NK et al. Open Forum Infectious Diseases 1, S214-S214, 2014.
4 Shrestha NK et al. Antimicrob Chemother 73, 1972-1977, 2018.
5 Norris AH et al. Clinical Infectious Diseases 68, e1-e35, 2018.