As published on TheHill.com.
By Kathleen Jaeger
Executive Vice President and CEO
National Community Pharmacists Association
Medication adherence, or ensuring the proper use of medication, is a serious and growing problem, particularly with older Americans. It not only has serious health consequences, it's also a major contributor to rising healthcare costs. Ten years ago, the costs of non-adherence—such as hospitalizations and other costly medical treatments—was estimated to be $177 billion annually, according to researchers Ernst and Grizzle of the University of Arizona's College of Pharmacy. In 2009, the research group NEHI released a study estimating the potential costs to be as high as a staggering $290 billion each year.
That's roughly 13% of all U.S. health care costs—about the same amount that Americans spend on prescription drugs. Put another way, for every dollar spent on prescription drugs, we pay another dollar treating the problems resulting from their improper use.
Community pharmacists play a vital role in maximizing both the health and economic benefits of adhering to prescribed medication regimens and reining in the soaring costs of non-adherence. Recognizing this, U.S. Senators Kay Hagan (D-N.C.), Sherrod Brown (D-Ohio), Al Franken (D-Minn.) and Tim Johnson (D-S.D.) and Representatives Cathy McMorris Rodgers (R-Wash.) and Mike Ross (D-Ark.) have introduced critical legislation that would help to reduce health care costs and improve patient outcomes by making more patients eligible for Medication Therapy Management, or MTM, in the Medicare Part D prescription drug benefit. Presently, eligibility for MTM services is restricted to a subset of Medicare beneficiaries suffering from multiple chronic conditions, such as diabetes, high blood pressure or heart disease. This legislation wisely expands Medicare coverage to any beneficiary battling a chronic condition.
Through MTM, a pharmacist works directly with a patient to personally review their complete medication regimen. These sessions allow patients to get the most out of their medications, ensure they fully utilize cost-saving generic drugs where appropriate, and head off any interactions or other problems that can cause unnecessary health concerns and lead to expensive medical interventions. That's why this legislation has the strong support of the National Community Pharmacists Association as well as the National Association of Chain Drug Stores.
There is a growing body of evidence demonstrating both the money-saving power of Medication Therapy Management as well as the real need for these services. In Minnesota, patients enrolled in an MTM program experienced a reduction in health care costs from $11,965 to $8,197—a return on investment of 12:1—according to the American Pharmacists Association. In Senator Hagan's home state of North Carolina, Kerr Drug found that MTM programs helping seniors with Medicare can save upwards of eight dollars for every one dollar invested. As Kerr Drug has noted, a state initiative known as ChecKmeds, that predated Medicare MTM, enlists 500 community and retail pharmacists. Through the end of June 2010, they served 31,191 patients and achieved an estimated, cumulative cost savings of $34 million—well in excess of program outlays.
Moreover, a study published in the Journal of the American Pharmacists Association concluded that pharmacist-provided MTM services are more effective than mass mailings and other forms of MTM. And a new analysis released by the National Pharmaceutical Council argues that better health outcomes, whether through face-to-face MTM or other means, produce additional savings in other areas including workforce productivity, limited absences due to health and enhanced quality of life for employees and their families.
Community pharmacists are among America's most accessible and most trusted health care providers. We're able to work directly with patients to help them stay healthy through effective use of their medicines while also avoiding costly medical complications. This bipartisan legislation to expand Medicare's coverage of Medication Therapy Management services is the right prescription for reducing care costs and improving health outcomes.
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