MTM takes center stage at AMCP meeting

Medication therapy management (MTM) was the recurring theme at this year's Academy of Managed Care Pharmacy (AMCP) meeting, held recently in Seattle. The American Pharmacists Association led a working group of 11 pharmacy organizations to define MTM services in 2004. This year, a similar working group led by AMCP defined MTM programs. The resulting consensus document was presented at the AMCP meeting.

AMCP does not intend the new definition to be strict or confining. "We hope this description of quality practices, services, and programs will inspire creativity and innovation," said Judith Cahill, executive director of AMCP. "MTM programs by their nature must be evolving, flexible, and responsive to patient and healthcare system needs." The consensus document is available on the AMCP Web site- http://www.amcp.org/.

In the FEP's new MTM program, plan members receive one-on-one consultations with pharmacists who help them identify and resolve drug therapy issues. Lennard admitted that these are expensive interventions. However, the rising cost of drugs makes resolving medication issues more important and more affordable.

Patient response to FEP's MTM program has been very positive, and 46% of their medical conditions have improved as a result of the program. Faudskar, area VP of clinical services for Caremark, said he and his colleagues are still gathering data and will publish the results when they have a year of patient service data.

A study presented at the AMCP meeting illustrated a target for MTM. Patrick McCollam, Pharm.D., a research scientist at Eli Lilly, was an investigator for the study. He and his team looked at oral antiplatelets used among managed care outpatients.

These patients also tended to be on several other medications. Unfortunately, an alarming number of patients (35%) had discontinued their antiplatelet medication after just 30 days. Up to 50% of these same patients discontinued at least one other cardiac medication at the same time.

A single hospitalization due to acute coronary syndrome, on average, costs more than $14,000, according to another study by McCollam. Annual medical and prescription bills for the same group averaged nearly $29,000. Patients who had recurrent episodes requiring hospitalization averaged nearly $13,000 in hospital bills. "This population encompasses all of the characteristics of good candidates for MTM," said McCollam.

THE AUTHOR is a writer based in the Seattle area.