Recently, the N.Y. Times, ran a story on medication therapy management programs (MTMPs). These programs typically involve either face-to-face or over-the-phone sessions between pharmacists and patients in retail stores or clinics. For example, insurance plans pay pharmacists to track patients, monitor cholesterol or blood glucose levels, and prod customers to change their diets or exercise. The goal is to reduce cost and improve patient outcomes by decreasing the frequency of patients taking contraindicated drugs, improving adherence, and providing a comprehensive medication review (CMR) to evaluate the potential interactions of drugs prescribed by multiple doctors. Examples of MTMs include the Wisconsin Pharmacy Quality Collaborative (where community pharmacies and health plans joined together to standardize MTM practices) and Mirixa (a private MTM firm which was founded by the National Community Pharmacists Association).
The American Pharmacists Association (APhA) even has a map summarizing MTM activities by state.
MTMPs have taken off since Medicare plans started covering medication therapy management programs in 2006. Currently, about one-in-four Part D beneficiaries are eligible for MTMPs. This CMS Fact Sheet provides an overview of the types of medication therapy management programs (MTMPs) currently in in operation during 2010 for Medicare Part D plans.
CMS requires Part D MTMPs to 1) enroll targeted beneficiaries using an opt-out method, 2) conduct the beneficiary target assessment at least quarterly, 3) offer a minimum level of MTM services including CMR, and 4) measure and report details on the number of CMR, number of targeted medication reviews, number of prescriber interventions, and change in therapy as a result of the interventions. Beneficiaries eligible for targeting include: i) beneficiaries who have a minimum of either 2 or 3 chronic diseases, ii) who are taking multiple part D drugs, and are likely to incur annual costs for covered Part D drugs that exceeds $3000.
The graphs below display the current state of the 2010 Medicare Part D MTMPs.
The American Pharamcists Association (APhA) Medication Therapy Management Digest (March 2010) also displays the frequency with which MTMs ‘always’ or ‘often’ provide the following services.
The following chart displays trends in MTM outcomes. Although it appears the MTM programs have gotten worse over time, the growing sample size (2007: 22, 2008: 28, 2009: 42) may have just allowed for less advanced MTM programs to bring down the average.
MTM is a great primary care service provided by pharmacist. They help ease out loads from overall health professionals and increases the overall quality of life of the people. It is a great news that it is started to be used widely in the United States and are quite successful. I am a little sad for my country, Thailand, for defining MTM as going out to visit people in the community and check for medication errors. It is funny going door to door and save each person from medication errors while they never prevented medication errors from the prescription source in the first place!
Anyways, good article. 🙂
MTM takes the lessons learned in the Asheville Project and helps provides better patient management through one of our most trusted healthcare resources, the pharmacist. Reducing unnecessary hospitalizations due to the wrong mix of medications along with improved adherence to appropriate drug therapies will benefit both patients and plan payors.