Medication therapy management is on the upswing, gaining in popularity with patients, providers and payers alike. That’s according to a 2011 MTM Industry Trend Report released in late September by Nashville-based PharmMD.

“MTM has seen tremendous growth across many industries and stands poised to gain an even louder voice in the broader care management market if the quality of services in MTM programs continues to improve,” the report said. In fact, the report estimated that the MTM industry is a $10 billion market today, and Bo Bartholomew, PharmMD’s CEO, said he believes that number is conservative.

“Considering telemedicine, Star Ratings (by Medicare), workers’ comp and accountable care organizations, the role of MTM can have such a large footprint. We’re probably very conservative in the formula we used to come up with that number,” he said.

Bartholomew and partners that included Nashville venture capitalist Clayton McWhorter founded PharmMD in 2005 as an MTM specialist. Medication therapy management is a term that has come of age since approval of the 2003 federal act that established Medicare Part D, the prescription drug plan for seniors enrolled in an approved plan. In 2006, Medicare Part D mandated some MTM services, and by then PharmMD was well on its way, having already established a list of private and commercial payers. Part D’s move was icing on the cake.

Using its proprietary technology, PharmMD gathers prescription information on covered individuals from a variety of sources, and then pharmacists work to ensure that each patient’s prescription picture is in focus. Are patients taking the right medications for their conditions? Are there chances for adverse drug interactions? Is the prescription therapy the most cost effective? Are the medications achieving the desired results? Included in PharmMD’s service is the creation of a Personal Medical Record, where patients find all their medications listed in one place and have the opportunity to add additional information regarding vitamins, herbal supplements and over-the-counter medications.

About 70 professionals work in PharmMD’s Brentwood headquarters, including pharmacists in management roles. Yet, the company contracts with pharmacists in communities nationwide who interact with patients one-on-one. “On the front end of our consultations, we actually explain our role now. In many cases, a patient will talk to a patient-engagement specialist to answer their questions before they talk to a pharmacist,” Bartholomew said. “Once they (patients) understand our role, we have phenomenal engagement and appreciation. There is a lot of money saved for the individual patients themselves, which all of us would appreciate.”

The model is proving itself, and the results of the Trend Report bear that out. The report found that MTM continues to have high satisfaction ratings with 94 percent of customers stating they would recommend the service to a friend, and 89 percent stating that pharmacists offered help that could not be obtained from anyone else. Several health plans saved more than $30 million annually by using an MTM service to help control costs and improve the health outcomes of their beneficiaries.

“As we’ve been growing, the clients really view us as their partner. In many ways, we are the experts in this space,” Bartholomew said. “We live and breathe this every day.”

That’s why PharmMD embarked on the Trend Report. The company had been informally tracking market trends and sharing their findings when clients asked for guidance and benchmark reporting. Last year, the company compiled a formal report, but released it only to clients and close stakeholders. Amplified interest in the findings and an interest in transparency prompted PharmMD to release the 2011 edition publicly, Bartholomew said. While pharmacy benefit managers each year release the Drug Trend Report that covers costs and utilizations, information was lacking when it came to evidence-based utilization of MTM and its market opportunities, he noted.

Brad Tice, PharmD, is the company’s chief clinical officer, and he says physicians in particular are starting to take note of what MTM has to offer. “There has been a lot of noise in the marketplace from other kinds of companies just focused on cost savings,” he said. “Our ability to take the medical and the pharmacy and put them together helps us to be more of a partner with the physicians as they get to see what’s going on with their patients outside of their office. They can see if the patients are taking the medications, getting them filled, following their instructions. So when the patient comes back into the office, they’re not guessing as much, and they have better information to work from. The more they get to see that, the more they become a partner and onboard.”

Tice predicted that the Centers for Medicare and Medicaid Services will continue to increase reporting requirements, and the Five Star Quality Rating System eventually will embrace more MTM requirements. “More of the pharmacy measures are being incorporated into those Star Ratings to become even more prominent for the health plans moving forward,” he said.

When it comes to Medicaid, 14 states offer some type of MTM benefit and, according to the Trend Report, more are considering the option. At this time, Tennessee and its TennCare program aren’t on the list. Asked if Tennessee should be, Tice said, “Given the news headlines regarding the number of medications that Medicaid patients are using and the significance of the combinations of those medications, yes.” Then he added, “It’s a common-sense approach. Everyone can understand that people need to be using medications appropriately to improve care and save money and to prevent waste. There’s a bipartisan message there.”

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