CONFIDENTIAL AND PROPRIETARY
share of their plan’s pharmacy benefit costs. The program seeks to optimize member treatment by monitoring their medication records, identifying potential issues and, when necessary, providing interventions. Goals of our MTM program are to help patients understand their medications, avoid inappropriate or potentially dangerous medications, and increase compliance with medication regimens.
A successful MTM program is intended to optimize member outcomes by reducing:
The use of duplicative medications
The use of medications without indication
The use of multiple medications where a combination product can be used
The instances of complex regimens, if appropriate
The instances of members with a chronic-disease state not on medications recommended by national practice guidelines
The dispensing of inappropriate medications to the elderly
The instances of members not adhering to medication regimen as prescribed by their doctor
The instances of members incorrectly taking medications in drug therapies that are new to them
By working to achieve these goals, the quality of patient care increases while overall healthcare costs may decrease.
Walgreens Health Services’ MTM program complies with the guidelines set by CMS. Our comprehensive program is supported by custom-designed technology solutions, in- store, face-to-face interventions with pharmacists, and telephone interventions with pharmacists in our clinical care center. Although discouraged, both physicians and patients are given the option to decline MTM services.
Program Design and Components
Our MTM program offers the following components:
Appropriateness of therapy (AOT): Pharmacists are notified when therapeutic additions are recommended to optimize treatment. This notification is based on the member’s disease state and nationally recognized guidelines (e.g., a patient with diabetes not on an ACE inhibitor or a lipid-lowering agent). When required, the pharmacist will contact the prescribing physician regarding the rationale and benefits of the intervention. If the clinical recommendation is approved by the physician, the pharmacist will then discuss the medication addition with the member and explain the health benefits associated with the therapy change. The pharmacist should also discuss the benefits of medication adherence. If the physician does not approve the therapy change, the pharmacist will only dispense the member’s original prescription. Inappropriate medications in the Elderly (IMIE): With age, a person’s metabolism of medications slows, leading to an increased risk for adverse events. Our MTM Clinical Care Center pharmacists have developed a list of drugs based on the Beers’, Zhan’s
Walgreens Health Initiatives – Pharmacy Manual