Retail Pharmacist MTM Roles Supported by US House


More than 40 members of the US House of Representatives have expressed support for greater pharmacist roles in improvements made to Medicare Part D's medication therapy management (MTM) program.

More than 40 members of the US House of Representatives have expressed support for greater pharmacist roles in improvements made to Medicare Part D’s medication therapy management (MTM) program.

The 24 Republican and 20 Democratic members of Congress recently signed a letter to US Department of Health and Human Services Secretary Sylvia Mathews Burwell discussing

enhanced MTM models

that would lead to “better alignment of incentives” for those involved in the program, including Part D prescription drug plans, prescribers, pharmacies, and the US Centers for Medicare and Medicaid Services (CMS).

CMS announced plans to

improve MTM

with its Part D Enhanced MTM model in September 2015. The enhanced model aims to look at additional incentives and flexibilities to achieve the goals of the program.

Some of those goals include increased communication with pharmacists, prescribers, and patients; improved patient knowledge; reduced medication problems; and improved compliance with medication protocols.

The enhanced MTM model test will launch in January 2017 in the following Part D regions over a 5-year period:

  • Region 7 (Virginia)
  • Region 11 (Florida)
  • Region 21 (Louisiana)
  • Region 25 (Iowa, Minnesota, Montana, Nebraska, North Dakota, South Dakota, Wyoming)
  • Region 28 (Arizona)

“We believe the proposed enhanced MTM model to be a positive step forward in improving the Part D MTM program,” the letter from the members of Congress read. “However, we also believe that without the participation of retail community pharmacists, the testing of enhanced MTM models will fall short of achieving the maximum potential in terms of positive outcomes and impact on beneficiary health.”

Some of the medication adherence concerns that the Congressional members noted were:

  • Nonadherence costs the United States $290 billion annually and makes up 13% of total health care expenditures.
  • Patients with several chronic conditions comprise two-thirds of all hospital admissions and are 100 times more likely to have a preventable admission. These patients with several chronic conditions visit many different physicians in a year and receive around 50 prescriptions annually on average.
  • MTM is currently poorly integrated into health systems.
  • The MTM program was expected to see more enrollment and use since 2006, and despite improvements from CMS since then, there is still work to be done.

The Congressional leaders called for retail pharmacists to be included in the enhanced MTM models that will be tested, citing how pharmacists have been shown to improve patient health, reduce costs through fewer hospitalizations and readmissions, and increase patient involvement in their own medication management.

“Our seniors deserve the most robust and effective MTM program possible—one that includes the utilization of the most trained and highly skilled providers medication management services: local retail community pharmacists,” the letter read.

The National Association of Chain Drug Stores (NACDS) released a


praising the letter to Burwell.

“NACDS appreciates the engagement of these Congressional leaders who have urged retail pharmacy’s participation in this program,” said NACDS President and CEO Steven C. Anderson, IOM, CAE, in a press release. “The bipartisan support for this effort is consistent with the strong support for the MTM Empowerment Act in the current and prior Congresses, and that shows the strong interest in leveraging the expertise and accessibility of pharmacists to confront the severe health consequences and the $290 billion in annual costs that are associated with not taking medications as prescribed.”

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