DEcIDE Research: Medication Therapy Management Programs

One goal of the 2003 Medicare Prescription Drug, Improvement, and Modernization Act (MMA) was to improve outcomes for people who have multiple chronic conditions and who may be prescribed a large number of medications. MMA permitted Prescription Drug Plans (PDPs) and Medicare Advantage Drug Plans (MA-DPs) to develop a wide variety of services known as Medication Therapy Management (MTM) programs. The purpose of MTM programs is to improve understanding of medications, increase adherence to treatment, and detect and reduce adverse events.

Individual MTM programs vary widely in their design. To gain a better understanding of the types of services provided by MTM programs, the Effective Health Care Program commissioned the DEcIDE Center at the University of Illinois-Chicago to collect information about MTM programs that were in operation in 2006.

The DEcIDE investigators developed a survey to investigate enrollment criteria, the services that are provided, and how they are provided within large and/or national MTM programs. Completed surveys were obtained from 70 health insurance plans that work with 21 unique MTM programs and service 12.1 million Medicare enrollees. This represents about 60% of all people who were enrolled in PDPs and MA-DPs at the time of the study.

Nearly all (90.5%) of the MTM programs required that enrollees have at least two chronic diseases, and about half had restrictions based on the type of chronic disease. The MTM programs provided from two to seven services. Three-quarters provided patient education programs, and 70% offered adherence services. Sixty percent provided medication reviews to compile comprehensive medication lists for patients, and 55% also provided assessments to determine possible adverse drug interactions. Other services, e.g., patient counseling or physician consultation, were offered by fewer than half of the programs surveyed. Nearly all the programs provided the services by in-house call centers and mailed interventions.