|
October 2017
Medication therapy management: A tool to help patients reach their treatment goals
Did you know?
- The preventable medical costs associated with medication non-adherence and improper medication use measure in the hundreds of billions of dollars each year.1
- Half of patients don’t take their medications as prescribed and one-third never even fill their first prescription.2
- An estimated 1.3 million people who fill a prescription for the first time experienced a preventable adverse drug reaction that required an emergency room visit and more than 350,000 were hospitalized.3 This is nearly twice the rate from the same period just 10 years ago.4
1Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clinic Proceedings. 2011; 86(4):304-14.
2Iuga AO, Mcguire MJ. Adherence and health care costs. Risk Management and Healthcare Policy. 2014; 7:35-44.
3Levine PA. The redesign of JAMA otolaryngology-head & neck surgery and the JAMA network journals: not just another pretty face! JAMA Otolaryngol Head Neck Surg. 2013; 139(8):772.
4Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006; 296(15):1858-66.
Blue Cross Blue Shield of Michigan’s Medication Therapy Management program for 2017 can help address the human and financial toll that medication non-adherence, improper medication use and adverse drug reactions can have on patients.
Medication therapy management is a pharmacist-provided service that can help patients get the most out of their medications. Pharmacists conduct a medication review with eligible members, either in person or over the phone, and discuss all aspects of medication usage with the member.
The Centers for Medicare & Medicaid Services has made medication therapy management a free benefit that’s provided by all Medicare Part D prescription drug plans to eligible members.
Eligibility
Medicare members who are eligible for Blue Cross Blue Shield of Michigan’s Medication Therapy Management program for 2017 must meet all of the following criteria:
- Have at least three of the following chronic medical conditions:
- Diabetes
- Heart failure
- Chronic obstructive pulmonary disease
- Hyperchlolesterolemia
- Hypertension
- Take at least eight Part D medications
- Be reasonably expected to incur at least $3,919 worth of drug expenses in one calendar year
These members will be sent a welcome packet in the mail inviting them to participate. After finishing a medication review with a member, the pharmacist will send the member a summary of what was discussed, any issues that were addressed and a current medication list. In addition, the member’s Part D claims will be monitored throughout the year to check for any new issues or major changes in therapy.
Benefits
Here are some of the benefits of medication therapy management:
- Improves medication adherence
- Identifies drug interactions with other drugs, foods, vitamins and herbal supplements
- Suggests possible therapeutic options to help reduce the financial burden of medication use
- Reconciles medications across multiple prescribers
Close coordination between prescribers and the medication therapy management team will help you get the most from the program. It’s an important tool for helping patients reach their treatment goals, but you may need to encourage eligible patients to take advantage of the services.
Let your eligible patients know that the program:
- Is free and part of their prescription drug benefit
- May be done over the phone at their convenience
- Can help them better manage their medications and, possibly, decrease costs
- Can identify potential adverse reactions between drugs, foods, vitamins and herbal supplements
For more information on this topic, send an email to Kim Moon, a manager with Pharmacy Services, at kmoon@bcbsm.com. | 
