One cost saving strategy used by some health insurance companies is to contract with a drug distributor for chemotherapeutic agents which are shipped to the patient's home. These are held by the patient until taken to the physician's office ("brown bagging") for administration. While saving the insurance company money this process can be disastrous for the patient if a failure occurs.


NOTE: The term "brown bagging" is also used for the practice for a patient to bring all medications to a physician or pharmacist for review.


Quality of the preparation:

(1) adherence to prescription

(2) source material within dates (not expired)

(3) proper dilution and mixing

(4) prevention of contamination

(5) proper labeling

(6) infusate within dates (not expired)


Adequate protection during transport, both from distributor to patient and from patient to physician:

(1) against excessive heat or cold

(2) against spillage of toxic compounds


Adequate storage at the patient's home.


Prevention of delays:

(1) in delivery relative to a therapy cycle

(2) due to the need to prepare an infusion while the patient is waiting


Quality of process:

(1) problem feedback and troubleshooting mechanism

(2) acceptance of responsibility for failures


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