Nationwide estimates of medication therapy management delivery under the Medicare prescription drug benefit

Deborah L. Pestka, Alan J. Zillich, Antoinette B. Coe, Karen B. Farris, Omolola A. Adeoye, Margie E. Snyder, Joel F. Farley

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1 Scopus citations

Abstract

Objective: To describe the national delivery of medication therapy management (MTM) to Medicare beneficiaries in 2013 and 2014. Methods: Descriptive cross-sectional study using the 100% sample of 2013 and 2014 Part D MTM data files. We quantified descriptive statistics (counts and percentages, in addition to means and standard deviations) to summarize the delivery of these services and compare delivery between 2013 and 2014. Results: Medicare beneficiaries eligible for MTM increased from 4,281,733 in 2013 to 4,552,547 in 2014. Among eligible beneficiaries, the number and percentage who were offered a comprehensive medication review (CMR) increased from 3,473,004 (81.1%) to 4,394,822 (96.5%), and beneficiaries receiving a CMR increased from 526,203 (12.3%) to 767,286 (16.9%). In 2014, CMRs were most frequently delivered by telephone (83.2%) and provided by either a plan sponsor (29.0%) or an MTM vendor in-house pharmacist (35.0%). In 2014, pharmacists provided 93.5% of all CMRs, and other providers (e.g., nurses and physicians) provided 6.5% of CMRs. Few patients who received a CMR received more than 1 within the same year (2.2% in 2014). Medication therapy problem (MTP) resolution among patients receiving a CMR stayed roughly the same between 2013 and 2014 (19.2% vs. 18.7%, respectively; P < 0.001). Finally, most beneficiaries (96.9% in 2014) received a targeted medication review, regardless of whether a CMR was offered or provided. Conclusion: More than 4 million Medicare beneficiaries were enrolled in Part D MTM in both 2013 and 2014. However, less than 20% of eligible beneficiaries received a CMR during those years, and rates of MTP resolution were low. Future evaluation of Part D MTM delivery should examine changes in eligibility criteria and delivery over time to inform MTM policy and changes in practice.

Original languageEnglish (US)
Pages (from-to)456-461
Number of pages6
JournalJournal of the American Pharmacists Association
Volume60
Issue number3
DOIs
StatePublished - May 1 2020

Bibliographical note

Funding Information:
The authors would like to acknowledge the contributions of Eric Berger, MS, for programming the tables and data to support this project. Deborah L. Pestka, PharmD, PhD, Research Scientist, College of Pharmacy, University of Minnesota, Minneapolis, MN Alan J. Zillich, PharmD, FCCP, Professor, Purdue College of Pharmacy, Purdue University, West Lafayette, IN Antoinette B. Coe, PharmD, PhD, Assistant Professor, College of Pharmacy, University of Michigan, Ann Arbor, MI Karen B. Farris, PhD, FAPhA, Charles R Walgreen III Professor of Pharmacy Administration and Chair, College of Pharmacy, University of Michigan, Ann Arbor, MI Omolola A. Adeoye, PharmD, Hook Drug Foundation Fellow in Community Practice Research, Purdue College of Pharmacy, Purdue University, West Lafayette, IN Margie E. Snyder, PharmD, MPH, FCCP, Associate Professor, Purdue College of Pharmacy, Purdue University, West Lafayette, IN Joel F. Farley, PhD, FAPhA, Professor, College of Pharmacy, University of Minnesota, Minneapolis, MN

Funding Information:
Disclosures: Antoinette B. Coe is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number KL2TR002241. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Karen B. Farris reports consulting with QuiO, outside the submitted work. Omolola A. Adeoye is supported by the Indiana Clinical and Translational Sciences Institute funded, in part by Award Number TL1TR001107 (A. Shekhar, PI) from the National Institutes of Health, National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award. Margie E. Snyder reports grants and personal fees from Agency for Healthcare Research and Quality and personal fees from Westat, Inc., outside the submitted work. The other authors declare no other relevant conflicts of interest or financial relationships.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural

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