The Value of Medication
Therapy Management
Services
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
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
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
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
Medication Therapy Management Process
 Today’s wants
and needs
 Responsibility
to participate
in information
sharing and
decision making
 Evaluate appropriateness, effectiveness,
safety, and compliance with medications
 Identify drug therapy problems
CARE PLAN
 Resolve drug therapy problems
 Establish goals of therapy
 Interventions
FOLLOW-UP
 Evaluate progress in meeting goals of
therapy
 Record actual patient outcomes
 Reassess new problems
Experienced Decision Making
Patient
Medication Experience
ASSESSMENT
Practitioner
 Philosophy of Practice
 Social Obligation
 Responsibility to
identify, resolve,
and prevent
drug therapy
problems
 Patient-centered
approach
 Caring
Therapeutic Relationship
MTM Pharmacist/Prescriber
Relationship
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
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.
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
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
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