The Value of Medication Therapy Management Services

1
The Value of Medication Therapy Management
Services
2
Purpose of Medication Therapy Management Services
(MTMS)

• To optimize therapeutic outcomes
• To decrease the likelihood of adverse events
• To enhance patient understanding and adherence
• To reduce overall healthcare spending

American Pharmacists Association
3
Definition of MTMS

• Services provided by a pharmacist that improve
  treatment outcomes for individual patients
• A professional service to promote the safe and
  effective use of medications
• A way to provide better care for patients
• Promotes collaboration among the patient, the
  pharmacist, and the patients other health care
  providers
• .

Bluml BM. Definition of medication therapy
management development of professionwide
consensus. J Am Pharm Assoc. 20054556672
4
MTMS Activities

• Assess patients health status
• Devise medication treatment plan
• Select, modify and administer medications
• Review current medications and identify
  drug-related problems
• Communicate care to other providers
• Provide patient education
• Refer patients for broader disease management
  services

APhA. Pharmacists Improving Care and Reducing
Costs for Your Plan Participants. Available at
www.pharmacist.com
5
Components of the MTMS Core Elements Service
Model

• Medication Therapy Review (MTR)
• a review of all medications including
  prescription, nonprescription, herbal products,
  and other dietary supplements
• Personal Medication Record (PMR)
• Medication-Related Action Plan (MAP) for the
  patient
• Intervention and/or Referral
• Documentation and Follow-Up

APhA. Pharmacists Improving Care and Reducing
Costs for Your Plan Participants. Available at
www.pharmacist.com
6
Medication Therapy Management Process
ASSESSMENT
? Evaluate appropriateness, effectiveness,
safety, and compliance with medications ?
Identify drug therapy problems

Practitioner
Patient

CARE PLAN
Experienced Decision Making
Medication Experience
? Resolve drug therapy problems ? Establish goals
of therapy ? Interventions
? Philosophy of Practice ? Social Obligation ?
Responsibility to identify, resolve, and
prevent drug therapy problems ?
Patient-centered approach ? Caring
? Todays wants and needs ? Responsibility to
participate in information sharing and
decision making
FOLLOW-UP
? Evaluate progress in meeting goals of therapy ?
Record actual patient outcomes ? Reassess new
problems
Therapeutic Relationship
7
MTM Pharmacist/Prescriber Relationship
8
Medication Recommendations

• MTM pharmacists may make recommendations in
  several ways
• Directly to the patient
• Over-the-counter changes, general adherence tips,
  managing side effects
• Through the prescriber
• Changes in prescription medications
• Directly to the patient under a collaborative
  practice agreements
• Allows pharmacists to make adjustments to
  prescription medications via protocol

9
Summary of evidence of Value of MTMS

• Economic
• Multiple studies have shown positive results on
  total health care costs, creating a positive
  return on investment
• Clinical
• Multiple studies have indicated improved in
  clinical outcomes, specifically in diabetes,
  asthma, hypertension and dyslipidemia
• Humanistic
• The Asheville project has demonstrated reduced
  employee sick days and increased productivity.

Fera T., Bluml BM, Ellis WM. JAPhA. 2009
49(3) 383-391. Isetts, et al., J Am Pharm
Assoc. 200848(2)203-211 Bunting BA, Cranor CW.
JAPhA. 2006 46133-147. Cranor CW, Bunting BA,
Christensen DB. J Am Pharm Assoc. 200343173-84.
10
Whats in it for the payer?

• MTMS results in decreased overall healthcare
  costs
• Prescription costs will likely increase, but this
  is compensated by an overall decrease in costs
• Pharmacists can provide MTMS as a member of the
  health care team and medical home model
• Increased member satisfaction
• Mechanisms for MTMS claims processing are well
  established through CPT codes

11
Whats in it for the patient?

• MTMS provides patients with improved health
  outcomes from optimizing medication use
• This includes decrease emergency department
  visits and hospitalizations
• Increased understanding of medications and
  disease management
• Improved quality of life

12
Summary

• Medications are a standard in the care of chronic
  diseases
• Pharmacist delivered Medication Therapy
  Management Services are well documented to
  decrease health care costs while increasing the
  quality of health care