Michael Evans, RPh, Describes Geisinger's Approach to MTM Programs

Michael Evans, RPh, director, ambulatory clinical pharmacy programs, Geisinger Health System, says that medication therapy management (MTM) programs present various challenges. In particular, those challenges include medication reconciliation, ensuring that patients are adherent to their medications, and clinician prescribing practices. Dr Evans explains that with biologics and other high-cost prescription medications, clinicians often incorrectly assume that a patient will adhere simply because they are in need of a certain drug. However, the likelihood is no different from any other chronic illness, in which the patient is adherent only 50% — or less – of the time.

“As we’ve interviewed and we’ve spent time with clinicians, they’re writing their prescriptions for the biologic, for the patient, and that’s where their therapy or their follow up for the patient typically ends,” Dr Evans says. “They assume since they’re writing the prescription, it’s a high dollar, high risk, the patient really needs it, they assume the patient’s adherent to the therapy.”

Dr Evans says that by involving pharmacists in a therapy regimen, the organization was able to take patients off medications they were not benefitting from and find other prescriptions that would produce the same outcome but at a lower cost. He says, “It’s a small number, a small percentage of patients, but it’s a large percent of our spend in the ACO so that’s why we’re targeting that population.”

He adds that keeping electronic health records up-to-date and providing the right medications to the right patients are additional challenges in medication management.