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 patient’s other health care providers . Bluml BM. Definition of medication therapy management: development of professionwide consensus. J Am Pharm Assoc. 2005;45:566–72

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 Patient Practitioner 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  Today’s 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. 2008;48(2):203-211 Bunting BA, Cranor CW. JAPhA. 2006; 46:133-147. Cranor CW, Bunting BA, Christensen DB. J Am Pharm Assoc. 2003;43:173-84.

10. What’s 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. What’s 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