Pharmacists Services Integral to Medicare Drug Benefit
Members of the Pharmacist Provider Coalition are encouraged that a recent educational piece released by the Centers for Medicare and Medicaid Services (CMS) emphasizes the important role of pharmacists’ medication therapy management (MTM) services in ensuring a high-quality drug benefit.
In its description of the new MTM benefit that will be offered to high-risk Medicare beneficiaries beginning in January 2006, the agency references pharmacists as the health care practitioner that will be paid to provide these services. The educational piece provides the pharmacists’ "brown bag consult," in which patients bring all their medications to discuss, as an example of how pharmacists can improve patients’ medication use. The Pharmacist Provider Coalition stresses that MTM services also include pharmacists educating patients about their medication regimen, monitoring their responses to drug therapy and coordinating care with patients’ physician to make any necessary adjustments.
“CMS recognizes that prescribing of medications alone do not necessarily improve patient outcomes, said Brenda Schimenti, Executive Director of the College of Psychiatric and Neurologic Pharmacists. “Providing high-risk seniors with access to pharmacists’ expertise for medication use and disease state management is an essential step in ensuring that those who take multiple medications do so safely.”
Patients who are eligible for medication management therapy services under the new drug benefit include individuals who:
Suffer from multiple chronic conditions (such as asthma, diabetes, hypertension, hyperlipidemia, and congestive heart failure),
Take multiple covered medications, and
Are identified as likely to incur annual costs for covered part D drugs that exceed a level specified by the Secretary of Health and Human Services.
“The most expensive medicine is the one that is not working for you,” said Judith A. Cahill, Executive Director of the Academy of Managed Care Pharmacy. “A pharmacist is a vital partner in making sure patients get the most appropriate medication and know how to use it.”
The Pharmacist Provider Coalition will work with the CMS, drug plan sponsors, and Congress to develop MTM programs and payment structure as the agency gears up for the January 2006 roll out of the benefit.
The Pharmacist Provider Coalition (PPC) unites seven national pharmacist organizations to advocate for improvements in the quality of care that Medicare patients receive from their medications. Member organizations include: Academy of Managed Care Pharmacy (AMCP), American College of Clinical Pharmacy (ACCP), American Pharmacists Association (APhA), American Society of Consultant Pharmacists (ASCP), American Society of Health-System Pharmacists (ASHP), and the College of Psychiatric and Neurologic Pharmacists (CPNP). The American Association of Colleges of Pharmacy (AACP) officially endorses the work of the coalition.