Medication Therapy Management (Express Scripts Medicaire)

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datamonkee
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Joined: Wed Sep 07, 2011 10:40 pm

Medication Therapy Management (Express Scripts Medicaire)

Post by datamonkee » Thu Jul 16, 2015 7:26 am

My father received a letter from Express Scripts that is offering something called "Medication Therapy Management". According to the letter, it's a free, "personal, private medication review with a pharmacist."

Have any of you had experience with this? Should he sign up to do this?

Thanks!

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heartwood
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Re: Medication Therapy Management (Express Scripts Medicaire)

Post by heartwood » Thu Jul 16, 2015 8:45 am

datamonkee wrote:My father received a letter from Express Scripts that is offering something called "Medication Therapy Management". According to the letter, it's a free, "personal, private medication review with a pharmacist."

Have any of you had experience with this? Should he sign up to do this?

Thanks!


I don't recall the name of the program but I had an unsolicited call from Express Scripts at the behest of my state Rx plan just last week. I was asked by a "pharmacist's assistant" if I wanted to participate. I asked how long it would take. I was told 15 - 20 minutes. She had a list of my meds and reviewed dosage and how often, asked if I was taking any others, or supplements or other things like calcium, vitamins, etc. I was then connected with a pharmacist (he may have said trainee?). He reviewed each med with me with an emphasis on switching to generic for the few non-generics I take. No pressure.

In the end I asked if I was obligated to participate again since I had been told at the outset that this was through my coverage with the state plan we have. He said no, it was no obligation. I said I would not participate again since I work closely with my doctors and have had issues with some meds, both proprietary and generic. My interest is good outcome based upon my doctors' interactions. The cost savings associated with a switch to a generic is not my focus. He was professional and seemed to know his field.

I think its a worthwhile idea that would aid some people, save the Rx plan money if you switch to a lower cost generic, and does get another set of eyes to look at all your meds at one time.

datamonkee
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Re: Medication Therapy Management (Express Scripts Medicaire)

Post by datamonkee » Sat Jul 18, 2015 9:17 am

Thanks for the reply. It has given me some insight into how the program operates.

Mudpuppy
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Re: Medication Therapy Management (Express Scripts Medicaire)

Post by Mudpuppy » Sun Jul 19, 2015 4:15 pm

This program is likely intended to lower insurance costs by recommending alternatives that have a lower insurance payment. However, your father really should discuss medication with his physician. At best, this program might give some ideas of low-cost alternatives to discuss with the physician. But if there's a medically valid reason for using the more expensive option, then that should take priority. And that's a conversation to be had with his physician, not a pharmacist.

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grap0013
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Re: Medication Therapy Management (Express Scripts Medicaire)

Post by grap0013 » Mon Jul 20, 2015 7:46 am

Mudpuppy wrote:This program is likely intended to lower insurance costs by recommending alternatives that have a lower insurance payment. However, your father really should discuss medication with his physician. At best, this program might give some ideas of low-cost alternatives to discuss with the physician. But if there's a medically valid reason for using the more expensive option, then that should take priority. And that's a conversation to be had with his physician, not a pharmacist.


^This is a guess and not a very good one. Guessing when one does not know can be dangerous.

Here is a Medication Therapy Management (MTM) definition:

"Medication therapy management (MTM) is medical care provided by pharmacists whose aim is to optimize drug therapy and improve therapeutic outcomes for patients. Eleven national pharmacy organizations adopted this definition in 2004."

It has nothing to do with direct medication costs. MTM has been found to improve patient outcomes which can lower costs for organizations and that's why this service is becoming more popular.

The average clinic physician uses only 14 different medications and pharmacists more often than not, know pharmacotherapy better than the physician and yes you should ask your pharmacist if there is a valid reason for some of your more expensive treatment options if you are concerned about the price.

To the OP, yes your father should sign up for this. It is more likely than not to improve the effectiveness, safety, and convenience of his medications.
There are no guarantees, only probabilities.

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