Patient therapy evaluation program administered by pharmacists shows significant cost savings for Medicare and for private health care plans

IQware MTM photo

Outcomes Pharmaceutical Health Care and Security Health Plan of Wisconsin today announced ground-breaking Medication Therapy Management (MTM) program results.
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In the evaluation, Security Health Medicare members receiving MTM services from local pharmacists resulted in, on average, over $600 per member in overall cost savings annually. Commercial members receiving the services resulted in over $500 in savings per year. Savings specific to drug product costs exceeded $200 per member, on average, within both the Medicare and commercial populations. This first-of-its-kind evaluation included over 100,000 members.
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“While current requirements for MTM services exist only in Medicare, as a health plan we understand the strategic importance of these services for our entire membership,” said Twila Johnson, Director of Pharmacy Services. “The results confirm the key role local pharmacists can play in assisting members and prescribers to optimize medication therapy.”
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Outcomes identifies medication treatment gaps and works with local pharmacists and prescribers to close these gaps, reducing drug costs and improving adherence. Security Health is one of over 30 US health plans that have adopted the Outcomes unified MTM platform which connects such plans with 39,000 chain, independent, consultant and health-system pharmacy providers across the country.
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Program results will be reported at the Academy of Managed Care Pharmacy (AMCP) Annual Meeting in Minneapolis, Minnesota on Friday, April 29.
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Steps you can take to be more informed about your medicines

Safe Medical Treatments: Everyone Has A Role

by Dorothy L. Smith, Pharm.D.

Don’t be afraid to ask questions! 

1. Remember, we are all consumers. The only way a person can make informed decisions and use medicines safely is to know what information is important to obtain from health professionals, how to incorporate the medication into your daily lifestyle, how to manage side effects, when to seek medical help and how to keep track of important information for the doctor and pharmacist.

2. Ask your doctor why YOU need the medicine being prescribed and how it is going to help you. Discuss any concerns you have about taking the medicine so that you have all the information you need to decide whether you want to take it. If you do not want to take the medicine, discuss this with your doctor so that a treatment more acceptable to you can be prescribed.

3. Ask your doctor or pharmacist if there is an FDA-approved Patient Package Insert (PPI) for the medicine you are taking. More and more pharmaceutical companies are developing these informational sheets. They are written in language consumers can understand and are reviewed by FDA for fair balance and clinical accuracy. Many companies are also posting the PPI on their website for consumers to read.

4. Since the average person forgets 50% of what the doctor told them by the time they arrive at the pharmacy, ask the pharmacist to go over all the instructions again.

5. If you would feel more comfortable speaking with the pharmacist in a private area, ask for it. More and more pharmacies have private counseling areas to ensure confidentiality and better learning.

6. Ask the pharmacist to show you the actual medicine so that you know which medicine is used to treat which symptom(s).

· Many people stop taking a medicine because they think they are allergic to it. Actually they may have had a minor side effect. Some allergic reactions can be very serious and require immediate medical treatment. If you have any questions about whether a symptom is an allergy or a side effect, always ask your doctor and pharmacist.

· Be sure you know how to administer the medicine correctly. Some medicines, such as inhalers to treat asthma, require complicated steps. Your doctor and pharmacist can show you the steps to follow when using an inhaler so that the medicine will reach your lungs and not get sprayed on the back of the throat where it will not work. You may want to ask the pharmacist to let you practice using the inhaler in the pharmacy.

7. A prescription label that states “Take 1 tablet three times a day” does not give you enough information. Ask your doctor or pharmacist to help you determine the best times to take the medication so you can easily work the dosage schedule into your daily activities, meal times and work. You will find it easier to remember to take your medicine if it fits in with your normal lifestyle.

8. Try not to adjust your medicine doses or take “drug holidays” without discussing this first with your doctor or pharmacist. Some medicines can have very serious side effects if they are stopped suddenly.

· Many prescription medicines can interact with each other as well as with over-the-counter products and herbal remedies. Your doctor and pharmacist should review your medicines at each visit and make sure that you are not taking two prescription medicines that can interact. It is important that you tell them if you are self-treating with any over-the-counter product or herbal remedies. Even better, ask them before you start self-treating!

· If you receive written instructions that just list side effects that could occur, ask for more information. You need to know how to recognize the early symptoms of common side effects and how to manage side effects that may be annoying but are minor. You also need to know when you should contact your doctor because of a side effect. If you do not understand a medical term, do not be embarrassed to ask what that term means. Keep asking until you understand it!

· If you have a side effect, you need to tell your doctor and pharmacist. You also need to tell them if you did anything to try to treat it–such as skipping a dose, stopping the medicine or taking an over-the-counter or herbal remedy. This information is important for them to include in both your medical record and pharmacy record.

· Some people find it helpful to keep a “medicine diary” they can take with them to their next doctor and pharmacy visit. This diary can help you remember important information to tell your doctor so the doctor can decide if you really had a side effect or if the symptom may have been caused by something else. Your diary can also help remind you of important questions you want to ask.

· Some medicines must be stored away from heat, light or moisture in order to keep their strength. Transdermal patches should not be thrown away where children can find them and put them on like Band-Aids. If you are traveling in a car during hot weather, don’t store your medicines in the glove compartment of the car. The heat can destroy the medicine and it may not work.

· Select your pharmacist with the same care that you select your doctor. You want a pharmacist who will take the time to counsel you at every visit and answer your questions. You should also expect to receive written information that you can take home. However, the written instructions should NEVER take the place of personal counseling. You need your questions answered so you can manage your medicines safely!

· Find out how many days in advance you should order your refills. Ask your pharmacist to develop a program to help remind you to get your refills.

· If you are having trouble remembering to take your medicine, it is important to let your doctor know this. Otherwise, your doctor may think that the medicine is not working and may prescribe another medicine that is less effective or has more side effects. All that really may be needed is to work out a more convenient dosage schedule for you.

· Be sure at each pharmacy visit to tell the pharmacist if you have had any problems with any of your other medicines. Your pharmacist can often provide helpful advice.