Clinician perspectives on infusion site-of-care shifts in pediatric inflammatory bowel disease: An anonymous national web-based survey.

Commercial payers and pharmacy benefit managers use site-of-care and specialty drug distribution policies (including white bagging and brown bagging) that can redirect infusion-based biologic therapies from hospital outpatient departments to alternate settings. We conducted an anonymous web-based survey distributed via a national pediatric gastroenterology (GI) listserv (February 13-27, 2026) to characterize perceived access barriers and decision drivers for acceptable infusion sites among pediatric inflammatory bowel disease (IBD) clinicians. Among 100 respondents, prior authorization/payer friction was most frequently rated as a major/severe pain point (66%). The highest-rated decision drivers were reaction management capability (88% very/extremely important), reliable communication back to the GI team (88%), patient experience (88%), and pediatric infusion expertise (87%). These findings highlight administrative burden as the dominant barrier and underscore the importance of safety capability and bidirectional care integration when pediatric patients with IBD are shifted across sites of care.