Pharmacy groups brief Congress on health, cost benefits of MTM

NEW YORK Making sure that medication therapy management is a part of any new healthcare reform legislation is a major priority for this industry, but it may be even more critical to the U.S. healthcare system.

 

Here’s why: according to Centers for Medicare and Medicaid estimates, $2.5 trillion will be spent on health care this year. Approximately 54% of that spend was assumed by private insurers and out-of-pocket costs. By 2018, the majority of that spend is expected to shift toward the government, CMS predicts, with an assumption of some 51% of the $4.4 trillion projected spend then.

 

Meanwhile, pharmacists do a lot more than just fill prescriptions, such as work with physicians to optimize therapeutic choices, and help patients understand their medications and how to take them. These types of services already help save billions each year in unnecessary hospitalizations and emergency room visits by preventing dangerous interactions and adverse effects.

Then there’s MTM.

Using diabetes as just one example, such programs as the Diabetes Ten City Challenge, a national program launched by the APhA Foundation in 2005 that today is saving up to $1,000 per year per patient through a pharmacist-driven patient intervention.

Walgreens Health Initiatives in 2006 determined that its MTM program netted a 2.5:1 return on investment, saving some $408,000 annually for each 100,000 covered.

Take either one of those studies and extrapolate those savings across the ever-growing Medicare population, and you have some real  potential to take a significant bite out of that $2.2 trillion in projected government healthcare costs within the next 10 years.

What’s real telling, however, is that Congress is listening to what pharmacy might be able to offer. This Tuesday, the National Association of Chain Drug Stores is hosting its first RxIMPACT Day on Capital Hill. Already, 60 leaders from over 20 states have committed to attend.