Drug Topics community pharmacy MTM programs- Printable version
|
As the Medicare Part D program reaches the halfway point of its second year, only a fraction of the prescription drug plans
are offering medication therapy management programs that are open to community pharmacists.
Only a few national and a handful of regional PDPs offer MTM programs with a community pharmacy component, as the new Drug Topics Community Pharmacy MTM programs chart indicates:
http://www.drugtopics.com/drugtopics/article/articleDetail.jsp?id=439877.
In creating the Medicare Part D drug benefit, the Centers for Medicare & Medicaid Services mandated that every PDP develop
an MTM program. To date, the vast majority of MTM sessions are conducted by direct mail or over the telephone by pharmacy
benefit managers and drug plan providers, leaving most community R.Ph.s with few options.
For many, the lack of involvement of community pharmacists in MTM represents a missed opportunity. "When the architects were
designing this new benefit, MTM services were described as the 'cornerstone,'" of the plan, explained the American Pharmacists
Association's president-elect Timothy L. Tucker, Pharm.D., in testimony before the Senate Committee on Finance in May. "But
most plans have fallen short of the mark."
There are, however, a few notable exceptions. Perhaps the largest MTM plan open to R.Ph.s to date is the Community Care Rx
(CCRx) program that is administered by Mirixa Corp., formerly Community MTM Services. The MTM component of the program began
in June 2006. According to CCRx officials, the plan administered 44,000 MTM sessions during the second half of last year alone—although
many of those sessions were conducted via telephone. Walgreens' PBM division also administers an MTM program that uses both pharmacists employed by the PBM as well as its own
store-based pharmacists. And Humana is one of the few major PDPs to offer its own program with significant participation of
community pharmacists.
MTM programs continue to appear outside of the Part D program as well. Over the past few years, several pharmacy companies
have begun to offer disease state management or MTM sessions to customers as a service, even without expectations of increased
reimbursement from drug plans. "Winn-Dixie saw MTM as an opportunity," Mike LeBlanc, director of pharmacy at Winn-Dixie, told
Drug Topics. "We viewed MTM as a perfect fit, a natural evolution of the job. And it's a great tie-in to Winn-Dixie's commitment to quality
of care."
In addition, a number of private and government health plans have started to offer smaller scale MTM programs, most of which
are administered by Outcomes Pharmaceutical Health Care. While most of these plans tend to be small and include a small population
of MTM-eligible beneficiaries, they represent the largest potential for community-pharmacy-based MTM growth.
Note: For the most up-to-date list of MTM programs open to community pharmacists, visit http://www.drugtopics.com/. If you know of any other MTM programs that should be included in the Drug Topics Community Pharmacy MTM chart, please let us know at drugtopics@advanstar.com
.
Drug Topics archives are now available on ModernMedicine.com, a new online resource designed to meet the evolving needs of physicians.