Table 1 Home administration practices per country
Country | Home therapy availability | Self-administration allowed | Patient training |
|---|---|---|---|
Argentina [23] | Available, first 3 infusions administered by HCP in hospital or infusion center, most home infusions administered by HCP | Yes, but not done as far as known for Fabry | N/A |
Available, organized by treating physicians for patients after a minimum of 12 agalsidase alfa or 3 velaglucerase alfa in-hospital infusions | Yes | N/A | |
Brazil [43] | Not available, but was allowed in some circumstances since COVID-19 pandemic | No | N/A |
Canada [44] | Available with agalsidase alfa | Yes | N/A |
Available, encouraged during the COVID-19 pandemic. May be considered for patients who are tolerating their infusions well | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver | |
Denmark [46] | Available, may be considered for patients who are tolerating their infusions well | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver |
France [46] | Available, may be considered for patients who are tolerating their infusions well | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver |
Available, patients must have uneventful ERT infusions in a hospital setting prior to initiating home therapy with infusions administered by HCP | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver | |
Available, first 3 infusions administered by HCP in hospital or clinic | Yes | Yes, HCP educates on hygiene, reconstitution, cannulation, administration, and disposal | |
Available, administered by HCP and may be considered for patients who are tolerating their infusions well | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver | |
Available, patients must demonstrate accurate preparation and administration of the infusion in a hospital. If a significant reaction occurs at home, patients are required to return to the hospital for their next infusion | Yes, patients must perform 5 self-administered infusions at home during office hours in case assistance is required. Patients have various levels of nursing dependency with home therapy (independent, semi-independent, etc.) | Yes, HCP educates on hygiene, reconstitution, cannulation, administration, and disposal | |
Slovenia [46] | Available, may be considered for patients who are tolerating their infusions well | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver |
Spain [46] | Available for some patients with infusions administered by HCP; most infusions administered in a day-clinic setting | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver |
Sweden [46] | Available, may be considered for patients who are tolerating their infusions well | Yes, for agalsidase alfa. Velaglucerase alfa application in process | Yes, given by treating physician and/or nurse to the patient/caregiver |
Switzerland | Unsure | No | N/A |
United Kingdom [28] | Available, first infusion administered by HCP in hospital. Patients with uneventful infusions must proceed to home therapy (HCP-supported or self-administered). Following a reaction, patients can return to the clinic for their next infusion | Yes, once patient expresses desire the HCP and care team assess competency, risk assessment, and safety. Self-administration discussed at clinic visits | Yes, HCP educates on hygiene, reconstitution, cannulation, administration, and disposal |
Unites States of America [20] | Available for velaglucerase alfa | Unsure | N/A |