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According to the National Institutes of Health, some level of chronic pain affects about 100 million people in the U.S. In addition, the National Institute of Allergy and Infectious diseases estimates that approximately 500,000 Americans suffer from primary immune deficiency disorders. That’s why healthcare companies that provide specialty pharmacy services to physicians and patients are growing in importance, especially as people look for more effective alternatives to long-term use of oral opioids and antibiotics. In this Q&A, Simon Castellanos, CEO of AIS Healthcare, a leading provider of targeted drug delivery (TDD) and infusion care solutions, discusses how AIS Healthcare is enhancing the lives of its patients.

Why do some chronic pain sufferers need specialty medicine?

Many people suffering from chronic pain simply can’t find relief from standard pain medications. For them, TDD is literally a lifesaver. Treating certain causes of pain in patients with specific needs can require using medications customized for the individual. Some pain sufferers don’t have the option to take certain mass-produced medicines. For instance, they might be allergic to certain dyes contained in regular pain medications they would otherwise take for their condition. 

Other pain sufferers need an alternative solution to oral opioids. Oral opioids are highly addictive and when they’re overprescribed or abused, they can cause serious harm.

How does AIS Healthcare help patients manage severe chronic pain?

AIS Healthcare creates customized medications tailored to patients’ needs and our TDD division makes it a priority to improve the lives of our patients so they can thrive, no matter their circumstances.

TDD provides patients with pain medication via a pump, also known as intrathecal delivered medication. Instead of taking a pill orally, patients receive continuous doses of their medication directly from the pump that is surgically implanted into their body. This method of delivery infuses the medication directly into the patient’s spinal canal, which is a much more effective way of directing the pain relief to the places in the body where that discomfort is occurring.

Can you talk more about alternative treatments for people who currently take oral opioids?

Of the approximately 100 million people in the U.S. who suffer from some level of chronic pain, several million patients use opioids for long-term management of that pain.

TDD has a long track record of helping patients suffering from severe chronic pain. Many of these patients initiated their journey in managing pain with physical therapy or less invasive alternative methods. Many of them moved on to taking oral opioids. Some have had surgeries which either didn’t relieve the pain or made it worse, and as a result, physicians have initiated a more targeted therapy.

Typically, patients moving away from oral opioids start with an implanted stimulator therapy — an implanted device that is connected to the patient’s spinal structure. Such devices provide stimulation to the nerves to mitigate pain.

Yet about 45% of patients who start with an implanted stimulator therapy have it fail in the first five years. For them, the alternative is either to go back to oral opioids or to have a pump implanted to manage pain.

The TDD therapy that AIS Healthcare provides is often for chronic patients who have failed every other way of treating pain. By the time they choose an implanted pump, it’s a life-sustaining therapy. 

Some patients also have access to a device called a personal therapy manager (PTM), a patient-activated pain control device that can deliver medication when the patients are going through breakthrough pain — a sudden pain increase that can occur in patients who already have chronic pain from arthritis, cancer, fibromyalgia, or other conditions. It’s controlled and managed, and there’s no ability to overuse the device. It allows the patient, at certain moments during the day, to manage their medication more effectively. AIS Healthcare’s nursing and pharmacy teams provide support and education for patients using PTMs.

Additionally, the medication and services that AIS Healthcare provides to these pain sufferers improves their quality of life for the rest of their lives.

How does AIS Healthcare help combat the opioid epidemic?

Because oral opioids work by passing through a patient’s blood system, they have the potential to damage a person’s kidneys and gastrointestinal system. Patients who take oral opioids for long periods of time can also develop other comorbid conditions.

Oral opioids are also easy to abuse or divert. As a result, many physicians avoid prescribing opioids, even for people with chronic pain.

AIS Healthcare’s TDD therapy provides its patients with customized pain medication via an implanted pump. Pumps can’t be misused the same way pills can. They are virtually impenetrable and cannot be tampered with, unlike tablets, which can be taken off a shelf, sold and/or misused. There’s no way to transfer pump medications to someone else.

The effectiveness of TDD to treat individuals whose pain increases over time, or whose tolerance of a pain medication increases, is also superior to oral medications. The benefits of oral opioids when used properly can also decrease over time. This usually means taking more pills. Alternatively, medications provided via a pump are highly concentrated, and the doses are easier to refine and customize for an individual patient as their needs change.

Safety is also improved because only health care professionals can increase a patient’s dosage. Pumps can only be programmed by a physician or a nurse acting under the direction of a physician. Patients cannot take more than required or more than prescribed, because they do not self-administer their pain medicine. Doses are programmed, managed, and carefully monitored, reducing overdose risk and abuse by an individual patient.

Finally, since pump medications directly enter the spinal canal, they avoid going through the body’s entire system, reducing the risk of side effects. Compared to an oral opioid, medicine delivered by a pump means there’s a far smaller chance of a patient developing comorbid conditions.

Annually, AIS Healthcare produces more than 140,000 prescriptions or around 550 each day. More than 34,000pump patients are served by AIS Healthcare’s TDD division each year. More than 40 pharmacists are dedicated to the preparation of these medications, and over 200 highly trained nurses support AIS Healthcare patients around the country. From our industry-leading pharmacies, AIS Healthcare can ship pain medication with overnight delivery to all 50 states.

How does AIS Healthcare support people living with immunodeficiency disorders?

Around 500,000 people suffer from primary immunodeficiency (PI) diseases in the U.S. PI is a group of about 400 chronic disorders in which the body’s immune system doesn’t function properly or is missing. When people with this disease get an infection — like a cold or infected cut — their body’s immune system doesn’t operate correctly, and they can contract more serious illnesses or infections like pneumonia.

People with PI often live with chronic pain and have issues such as arthritis, inflammation, or muscle aches.

To help sufferers of PI and other immunodeficiency conditions, AIS Healthcare’s Advanced Infusion Care (AIC) division offers a variety of treatments, including recently announced medications called GAMMAKED™, LEQEMBI™, and CUVITRU. These treatments use plasma from patients who have overcome diseases to treat people with a range of conditions.

Medications containing these immunoglobulins can be administered to patients intravenously by injection straight into the bloodstream. Through infusion therapies, people receive functional antibodies via intravenous replacement therapy.