WASHINGTON — Only about a week after its debut in the House of Representatives, legislation to expand Medicare patient access to medication therapy management (MTM) services has been introduced in the Senate.
Endorsed by the National Association of Chain Drug Stores and the National Community Pharmacists Association, the Medication Therapy Management Empowerment Act of 2013 (S. 557) was introduced Thursday by Sens. Kay Hagan (D., N.C.) and Pat Roberts (R., Kan.), along with the support of original co-sponsors Sens. Sherrod Brown (D., Ohio), Al Franken (D., Minn.), Tim Johnson (D., S.D.) and Amy Klobuchar (D., Minn).
The legislation aims to increase the number of Medicare Part D beneficiaries who qualify for one-on-one counseling sessions with a licensed pharmacist to any patient with a chronic medical condition, such as diabetes or hypertension. Currently, only patients with specific, multiple chronic conditions are eligible.
A similar bill, H.R. 1024, was introduced in the House last week by Reps. Cathy McMorris Rodgers (R., Wash.), Ron Kind (D., Wis.), Lee Terry (R., Neb.) and Bruce Braley (D., Iowa).
"NACDS appreciates the leadership of Sens. Hagan and Roberts in spearheading this commonsense legislation, as well as the support of original co-sponsors Sens. Brown, Franken, Johnson and Klobuchar. This bill can help patients understand the importance of taking their medications as prescribed," NACDS president and chief executive officer Steve Anderson commented about S. 557. "Innovative pharmacy services such as MTM help to improve patient health and health care affordability, especially for those suffering from chronic conditions such as diabetes, hypertension, asthma and other conditions."
NCPA noted that research shows MTM can yield significant savings. According to the association, a Minnesota study found a 12:1 return on investment for MTM, and Kerr Drug has reported that MTM programs for seniors in North Carolina have led to a 13:1 ROI.
"For many Medicare patients, the challenges of coping with chronic conditions require an expert’s consultation, and pharmacists are clinically trained in helping ensure their patients are getting the best possible results for their health," NCPA CEO B. Douglas Hoey said in a statement. "That’s why NCPA is once again pleased to support federal legislation to expand the number of seniors eligible for this service."
Congress created an MTM benefit for Medicare beneficiaries under the Medicare Modernization Act of 2003 by requiring MTM services for patients on multiple medications suffering from chronic conditions or diseases. Yet lawmakers said the value that MTM has demonstrated thus far warrants more seniors having access to those services.
"Medication therapy management is the type of commonsense, fiscally responsible program that should be expanded to benefit more seniors," stated Hagan. "In North Carolina, this program has saved tens of millions of dollars, but more importantly it has helped keep seniors healthy. I will continue working with my colleagues on both sides of the aisle to expand this program to more seniors so that we can keep improving health outcomes without increasing health costs."
Roberts noted that in some rural communities in his home state of Kansas, pharmacists may be the only health provider in towns. "MTM is an important tool in the pharmacists’ tool box for many patients but which can be critical for those suffering from chronic conditions," the senator explained. "The Medication Therapy Management Empowerment Act gives patients access to valuable counseling and management for their conditions and takes the essential steps to guarantee what we already know: that MTM will save the system money while providing higher-quality care for patients."
NACDS pointed to a recently released study from the Centers for Medicare & Medicaid Services, which showed that in comparison to Medicare beneficiaries with chronic obstructive pulmonary disease or congestive heart failure who didn’t receive any MTM services in 2010, those enrolled in MTM programs — and particularly those who received annual comprehensive medication reviews — experienced significant improvements in the quality of their drug regimens, and costs were saved.
And last November, the Congressional Budget Office (CBO) released a report finding that after reviewing recent research, CBO estimated that a 1% increase in the number of prescriptions filled by beneficiaries would cause Medicare’s spending on medical services to fall by roughly one-fifth of 1%, according to NACDS. The association said that in real-world terms, CBO’s analysis means that a 1% increase in overall prescription drug use nationwide would lead to an overall decrease of $1.7 billion in total health care costs, or a savings of $5.76 for every American
"Pharmacists are widely trusted health care professionals with extensive education. They are trained medication specialists who work collaboratively to help patients use medicines safely and stay healthy," Anderson added. "This legislation will go a long way in helping to further pharmacists’ ability to help improve patient health and make health care more affordable."
