New MTM Survey Finds Great Potential Remains for Medication Therapy Management to Help Patients and Reduce Costs, but More Adoption Needed by Health Insurance Plans

By Kevin Schweers

NCPA recently asked community pharmacists to share their thoughts on the current state of medication therapy management (MTM) in their pharmacy practice. In sum, most pharmacists reported that they are doing MTM cases and receive positive feedback from patients, yet the eligibility requirements are too stringent for this service to reach its full potential for cost savings and better health.

For those who may not know, medication therapy management sessions are formal consultations between a pharmacist and their patient to go over their entire medication regimen. MTM helps patients get the most value and therapeutic benefit from their medications, promotes utilization of cost-saving generic drugs where appropriate, and can prevent costly drug interactions or problems arising from inappropriate medication use.

The 58 community pharmacists we contacted reported that:

  • 78 percent of their pharmacies do MTM cases.
  • 93 percent do 10 or fewer MTM cases each month.
  • 86 percent are aware that Community CCRx has increased its fee paid for face-to-face pharmacy MTM cases, such as through Mirixa, from $60 to $100 this year.

Pharmacists doing MTM cases reported having satisfied patients. “I have found that these MTM’s are really very helpful and informative for my patients,” one observed, citing “many positive comments from patients.”

Research indicates that the cost-savings from MTM can be significant. One Minnesota study found a 12:1 return-on-investment for MTM. In North Carolina, Kerr Drug reports that MTM programs there helping seniors produced a 13:1 return.

The most common reasons cited for pharmacists not involved in MTM were the lack of case volume, low fees from insurance plans and not enough pharmacy staff.

“Most cases take several hours to prepare for, the majority of which is pharmacist time,” one said. “The fee is still inadequate.”

Another noted, “If we had many patients with similar problems so that preparation time could be spread among patients it could be profitable and therefore justifiable as a patient and business benefit.”

All in all, the survey also illustrates the need for bipartisan legislation in Congress endorsed by NCPA and the National Association of Chain Drug Stores. The Medication Therapy Management Benefits Act would expand MTM coverage in Medicare to all patients with a chronic condition.

Senate and House sponsors of this legislation include U.S. Senators Kay Hagan (D-N.C.), Sherrod Brown (D-Ohio), Al Franken (D-Minn.) and Tim Johnson (D-S.D.) Amy Klobuchar (D-Minn.), Ron Wyden (D-Ore.) and Representatives Cathy McMorris Rodgers (R-Wash.), Mike Ross (D-Ark.), Shelley Moore Capito (R-W.Va.), Joe Courtney (D-Conn.), Tim Griffin (R-Ark.), David Loebsack (D-Iowa), and Laura Richardson (D-Calif.).

To encourage your Member of Congress to support this legislation, click here to go to NCPA’s Legislative Action Center.

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