Medication Therapy Management Program Cost-Effectiveness

According to an analysis of pharmacy and medical claims among patients who received Medication Therapy Management (MTM)—a range of services provided to individual members to optimize therapeutic outcomes and to detect and prevent costly medication problems—an average decrease in overall costs was observed.

“MTM services allows pharmacists to provide patients with in-depth medication related education, consultation, and advice to help assure proper use of medications and also allows collaboration with the physician and other health care providers to develop and achieve optimal goals of medication therapy,” researchers explained.

For their study, researchers sought to analyze how pharmacist-led interventions, used to prevent and resolve medication-related problems through an MTM program, affect overall health care costs. The researchers compared study to control group cases.

The researchers selected individuals for inclusion in the study group if the member received an MTM intervention from a pharmacist in 2017 and was continuously enrolled in the Medicaid plan for 6 months pre- and post-intervention. For the control group, inclusion was determined if the member was identified for but did not receive an MTM intervention in 2017 and was continuously enrolled in the Medicaid plan for 6 months pre- and post-identification date. Further, the researchers matched study and control group cases using nearest neighbor 1:2 propensity score matching, and a cost savings analysis was performed on 3708 study group cases and 7416 matched controls using both pharmacy and medical claims.

According to the findings, pharmacy and medical claims across the study group showed an overall cost decrease, 0.05%, while the control group showed an overall cost increase, 9.8%. The researchers found that the average pre-MTM pharmacy and medical cost for the study group who received an intervention and the control group over 6 months was $8135 and $5464, respectively. Further, the post-MTM cost for the members who received an intervention and the control group over 6 months was $8130 and $5997, respectively.

The researchers found that the average cost savings in the study group over the control group was $536 per member per month, and the overall cost savings of the MTM program was calculated to be $ 3,977,891 annually which equated to an overall return on investment of $6:1.

“The data showed a mean decrease in overall costs in the study group and an increase in the control group,” the researchers concluded. “Additionally, mean cost savings in the study group over control group were overall favorable.”

This poster was presented during AMCP Nexus 2018.

—Julie Gould