Providing Effective MTM

In an era of shrinking dispensing fees,many of us have advocated a shifttoward a new model for the profession—one based more on counseling andless on simply dispensing drugs. MedicarePart D, despite all the stress and problemsit has generated, created just such anopportunity by including a requirement formedication therapy management (MTM).

Even though this part of the program isjust getting started, the potential is considerable.A few plans have set up pharmacy-centered MTM services. For example,about 120,000 patients are requiredto receive MTM by the end of 2006through the National Community PharmacistsAssociation's Community MTMprogram.

One might have expected pharmaciststo jump on this, given the many surveysthat have indicated we want to spendmore time providing patient-focusedservices. Feedback to date, however,shows that many of us are not takingadvantage of the opportunity.

Practical reasons for this exist. Whenresources are already overstretched, itis hard to justify hiring staff for a new,unproven line of business. Furthermore,each plan currently adds to our administrativeburden by requiring us to learnand use a different system. Perhaps thebiggest challenge is to change our ownmindset so that we see ourselves asproviders of services rather than justdrugs.

By making this shift, pharmacists canposition themselves to step into valuablenew roles. Research suggests that MTMcan reduce drug costs and, even moreimportant, the risk of adverse interactions.The Part D MTM requirement coverssituations in which patients are treatingchronic conditions with multipledrugs—the type of situation in whichpharmacists should excel in providingdrug therapy advice.

Now, it is up to us to demonstratethat we are the profession best qualifiedto provide this service.We need toshow both the ability and the desire toprovide MTM, and to demonstrate thatthis is a valuable service both forpatients and for plans.

If we accept the challenge and provideMTM effectively, we will begin to positionpharmacists as valuable resources foradvice. That, in turn, will pave the way forus to deliver more services in the future.

When creating the Part D MTMrequirement, legislators did not specifywho should deliver it, and many insurersare initially choosing to provideMTM by other means. If we do notdemonstrate that pharmacists are thebest providers of counseling services,we may be opening the door to allowothers to claim that role.

Mr. Eckel is professor and director ofthe Office of Practice Developmentand Education at the School ofPharmacy, University of NorthCarolina at Chapel Hill.