Since the passage of the Medicare Modernization Act over two decades ago, medication therapy management (MTM) has become a necessity for the 54.1 million Americans enrolled in a prescription drug plan. These patients battle numerous chronic diseases, with the Centers for Medicare and Medicaid Services listing Alzheimer’s disease, bone disease-arthritis, chronic congestive heart failure, diabetes, dyslipidemia, end-stage renal disease, HIV/AIDS, hypertension, mental health conditions and respiratory disease as qualifying conditions.
These diagnoses can be devastating, and patients often juggle many prescriptions and rising drug costs that culminate in an unclear and overwhelming care regimen. MTM—with services like interventions, annual comprehensive medication reviews, quarterly targeted medication reviews, and education—takes steps to empower patients as they cope with chronic diseases.
MTM boasts significant benefits for patients—expressed in cost savings and decreased hospital readmission rates. Providers often include MTM vendors, registered nurses, plan-sponsored pharmacists and physicians. For retail pharmacies, there is considerable merit in offering MTM due to their unique positions and functions in communities.
Retail pharmacists remain one of the most accessible health care providers. Serving in a community-oriented role, retail pharmacists see their patients 35 times a year, on average. Their long-standing relationships with patients through these routine interactions, combined with the medication expertise of all pharmacists, place retail pharmacists at an optimal point to provide MTM. Research of community-based pharmacist MTM, in comparison to other sources of MTM, illustrates this through enhanced benefits.
As mentioned, MTM as a general practice exerts a dampening influence on costs and hospital readmission rates. These benefits can be compounded when retail pharmacists lead the effort. For example, a 2015 study found a 6.9% readmission rate with retail pharmacist-provided MTM after discharge versus a 20% readmission rate with “usual care” (other sources of MTM).¹
Beyond patient outcomes, MTM can also provide financial benefits for retail pharmacies. Reimbursement opportunities from MTM, particularly those affecting star ratings and value-based care models, create incentives for pharmacies. One study conducted in rural Colorado estimated $17,528 profit when comparing revenue and pharmacist labor costs of comprehensive medical reviews alone².
However, MTM isn’t always a practical offering for retail pharmacies. The most often cited barriers first included insufficient time, followed by insufficient staff3. This is where centralized fulfillment can play a critical role.
By transferring repetitive work to automated facilities, central fulfillment can expand the time pharmacists have to conduct clinical services. MTM empowers patients; centralized fulfillment empowers pharmacists.
Data-rich insights allow for recommendations that can improve workflow, pertaining to the likes of staffing models and inventory management. The continued implementation of such analytics can continually expand the ability of retail pharmacies to explore opportunities for patient care beyond manual prescription fulfillment.
MTM is a worthy implementation and opportunity for increased clinical care at retail pharmacies. Central fulfillment has the powerful potential to support MTM’s goal of optimizing therapeutic outcomes. Considering the recipients of MTM often bear many medical burdens and worries, retail pharmacists can continue to meaningfully advance the care of patients who arguably need it most.