Medication Therapy Management

Topic(s):

AMCP supports medication therapy management (MTM) programs, which are a distinct service or group of services that optimize therapeutic outcomes for individual patients.² MTM services are independent of, but can occur in conjunction with, the provision of a medication product.  MTM is comprised of five core elements: medication therapy review, completion of personal medication records, a medication-related action plan, pharmacist intervention and/or referral, and documentation and follow up. Completion of a Comprehensive Medication Review  is one component of MTM performance that is included in the CMS Star ratings.

As the price of prescription medications continues to rise, MTM services promote safety, medication adherence, and the best possible clinical outcomes while helping to manage cost through avoidance of waste and duplicate therapy. Discontinuation of unnecessary therapy via MTM also reduces inappropriate use of medications, resulting in lower costs and avoidance of unintended side effects.² Pharmacists collaborate with the patient, caregiver, physician, and other health care professionals while providing MTM services to ensure the goals of medication therapy are achieved and the patient is empowered to be an active participant in their care.

AMCP believes that pharmacists and managed care organizations should be allowed to design and implement MTM programs that meet the needs of populations without undue external influence.  AMCP encourages further refinement of MTM program design and eligibility criteria, only when supported by real-world evidence. Expansion of MTM programs without ensuring sufficient benefit through outcomes could lead to an increase in healthcare cost without corresponding value. 

Revised by the AMCP Board of Directors, July 2023

Approved by the AMCP Board of Directors, July 2016

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²“Medication Therapy Management.” AMCP Managed Care Glossary. 2022. Accessed online: https://www.amcp.org/about/managed-care-pharmacy-101/managed-care-glossary

²Ferries, E., Dye, J., Hall, B., Ndehi, L., Schwab, P., & Vaccaro, J. “Comparison of Medication Therapy Management Services and Their Effects on Health Care Utilization and Medication Adherence.” Journal of Managed Care & Specialty Pharmacy. 2019 25:6, 688-695. Accessed online: https://www.jmcp.org/action/showCitFormats?doi=10.18553%2Fjmcp.2019.25.6.688

Legislative & Regulatory Position October 23, 2024

Provider Status for Pharmacists

AMCP supports the recognition of pharmacists as providers. When pharmacists are recognized as provider members of the health care team, patient outcomes improve, and patients report higher rates of satisfaction while overall health care costs are reduced. Recognized provider status would allow pharmacists to be reimbursed for providing health care services to patients. In a survey conducted in 2023 commissioned by Wolters Kluwer Health, 58% of Americans agreed that they are more likely to seek non-emergency medical care from a pharmacist.

Managed Care Practice Issues

Legislative & Regulatory Position April 26, 2024

Prescription Digital Therapeutics

AMCP supports increased access to Prescription Digital Therapeutics (PDTs). PDTs are software-based therapies that deliver clinical benefits to patients, either alone or in combination with other forms of treatment. These therapeutics require a prescription and are subject to oversight by the Food and Drug Administration (FDA). To be approved by the FDA, PDTs must demonstrate both safety and efficacy.

Digital Therapeutics