Bipartisan Senate Bill to Boost MTM Access for Seniors


Bipartisan legislation to improve access to medication therapy management (MTM) services for senior citizens enrolled in the Medicare program received a nod from the National Association of Chain Drug Stores.


Arlington, Va. — Bipartisan legislation to improve access to medication therapy management (MTM) services for senior citizens enrolled in the Medicare program received a nod from the National Association of Chain Drug Stores (NACDS). NACDS endorsed S. 776, the Medication Therapy Management Empowerment Act of 2015, introduced today by Sens. Pat Roberts (R-KS), a senior member of the Senate Finance Committee; Jeanne Shaheen (D-NH), co-chair of the Senate Diabetes Caucus; Sherrod Brown (D-OH), member of the Senate Finance Committee; and Mark Kirk (R-IL), member of the Senate Health, Education, Labor and Pensions Committee.

The legislation would amend The Social Security Act to allow Medicare Part D beneficiaries to become eligible for MTM services if they suffer from a single chronic condition that has been shown to respond well to improved medication adherence, resulting in better health outcomes and reduced overall medical costs. Specifically, the bill would provide access to MTM services for beneficiaries with diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD) and high cholesterol.

Health policy research group NEHI cites that only 50 percent of patients take their medications properly as prescribed by their doctor, which costs” the nation more than $290 billion annually in avoidable health spending annually.

There is overwhelming support showing that MTM improves medication adherence, including specific research showing the benefits for patients with diabetes, cardiovascular disease, COPD and high cholesterol.

In 2014, the Medicare Payment Advisory Committee (MedPAC) studied the effects of medication adherence on the Medicare program and found that patients newly diagnosed with congestive heart failure showed significant medical side savings.

In addition, a 2013 study by the Centers for Medicare & Medicaid Services (CMS) found that in comparison to Medicare beneficiaries with COPD or congestive heart failure who did not receive any MTM services in 2010, those who were enrolled in MTM programs experienced significant improvements in the quality of their drug regimens and costs were saved. The results were particularly impressive for those who received annual comprehensive medication reviews.

A 2013 study of published research on medication adherence, conducted by Avalere, concluded that patients who are adherent to their medications have more favorable health outcomes such as reduced mortality and use fewer healthcare services, especially hospital readmissions and emergency room visits.

The Congressional Budget Office (CBO) found “estimates that a one percent increase in the number of prescriptions filled by beneficiaries would cause Medicare’s spending on medical services to fall by roughly one-fifth of one percent.” In real world terms, CBO's analysis means that, nationwide, a one percent increase in overall prescription drug utilization would lead to an overall decrease of $1.7 billion in overall healthcare costs, or a savings of $5.76 for every person in the U.S.

“The evidence is mounting of the positive impact of MTM on patient health. Innovative pharmacist-provided services such as MTM are important tools in improving medication adherence, patient health and healthcare affordability,” said NACDS President and CEO Steven C. Anderson, IOM, CAE. “We commend the leadership of Senators Roberts, Shaheen, Brown and Kirk for their leadership in proposing this commonsense, bipartisan legislation that can help Medicare patients with chronic conditions understand the importance of taking their medications as prescribed, and help manage and improve their health.”

“We have recognized the value of pharmacists in the health system for many years. They are especially valuable for our Kansas communities and are sometimes the only health provider in our rural towns.” said Sen. Roberts. “MTM is an important tool in the pharmacists’ tool box for many patients but especially for those suffering from chronic conditions. 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. I urge my colleagues to support this bipartisan legislation.”

“Our bipartisan bill has the potential to improve care for seniors who need it the most while also reducing healthcare costs for our system as a whole,” Sen. Shaheen said. “Providing seniors with better access to counseling when it comes to the safe and proper use of their medication should be a matter of commonsense. It will make sure seniors are not only taking their medications properly but does so in a way that lowers healthcare costs.”

Medication therapy management (MTM) is a professional service offered by pharmacists and other qualified health practitioners that helps ensure medications are taken appropriately to help improve health, reduce the risk of adverse events, and help control healthcare costs. Congress created the MTM benefit under the Medicare Modernization Act of 2003 for Medicare beneficiaries by requiring MTM services for patients on multiple medications suffering from chronic conditions or diseases.

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