Medication Program for Seniors
December 27, 2007
New federally mandated programs intended to help older Americans use their medicines more effectively almost always base enrollment on the number of diseases diagnosed, types of diseases, and the number of medications prescribed, according to a new survey.
In the survey, led by Daniel Touchette, assistant professor at the University of Illinois at Chicago College of Pharmacy, researchers looked at 21 distinct medication therapy management programs offered by 70 health plans. The plans covered 12.1 million of the 20.7 million Medicare enrollees in the Part D prescription drug programs as of April 27.
The survey was released by the Chicago area DEcIDE (Developing Evidence to Inform Decisions about Effectiveness) Research Center and is the first of its kind in the United States. It was commissioned by the Agency for Healthcare Research and Quality and appears in the latest issue of the Journal of the American Pharmacists Association.
Medication therapy management is part of the Medicare Part D benefit that allows pharmacists to bill the federal government for counseling certain Medicare patients about their medication regimens. It took effect on Jan. 1, 2006 and was designed to provide a range of professional services to improve the safety and efficacy of drug therapy.
"Some programs focused on reducing the number of medications or on cost savings, while other programs focused on reducing potential adverse drug events, improving patient clinical outcomes or raising quality of life," Touchette said.
Patients who have multiple chronic conditions and take several medications are likely to incur high drug costs, according to the Centers for Medicare & Medicaid Services. Nearly 80 percent of Medicare beneficiaries have multiple chronic conditions, and 20 percent have five or more chronic conditions, with the latter group accounting for more than two-thirds of Medicare spending.
The Centers for Medicare & Medicaid Services purposely left the medication therapy management requirements vague for 2006, allowing the marketplace to experiment and evolve, Touchette said. Once the best practices are identified, the benefit will "likely become more prescriptive and restrictive in the coming years.
"Pharmacies need to take this opportunity to try different medication therapy management approaches and demonstrate conclusively just what pharmacists can do to help patients under this benefit," he said.
The survey also asked how patients learned of the medication therapy management programs. Mailed information, in-house call centers and personal meetings with contracted pharmacists were the ways most often mentioned.
The Chicago area DEcIDE Research Center, which is coordinated by UIC, is one of 13 research centers nationwide and the only one in the Midwest. UIC is part of a consortium that includes Northwestern University, the University of Chicago, the Blue Cross/Blue Shield Association and the Department of Veterans Affairs Midwest Center for Health and Policy Research.
The DEcIDE centers conduct research on the effectiveness of drugs and treatments for certain health conditions, helping to assist the Centers for Medicare & Medicaid Services manage the Part D drug benefit.
The survey was completed as part of a $300,000 contract through the Agency for Healthcare Research and Quality's DEcIDE network. The Chicago area DEcIDE Research Center currently has four contracts totaling $1.7 million.
CONTACT: Sam Hostettler, (312) 355-2522, samhos@uic.edu