Collaborative Practice

AMCP supports the concept of collaborative drug therapy management (CDTM) a formal partnership between a pharmacist and a prescriber that allows the pharmacist to manage a patient’s drug therapy. CDTM, also referred to as collaborative practice, allows pharmacists to use their unique skills and abilities to complement other types of care provided by collaborating professionals to optimize patient outcomes. When pharmacists practice under CDTM agreements, health care services and outcomes are optimized when compared with settings where pharmacists were not involved.

(See AMCP Managed Care Pharmacy Practice Positions – Collaborative Drug Therapy Management)

AMCP supports disease management as the concept of reducing health care costs, closing gaps in care, and improving quality of life for individuals with chronic conditions by preventing or minimizing the effects of the disease through integrated medical and pharmacy management. Disease management programs are designed to improve health outcomes and reduce associated costs from avoidable complications and medication adverse events by identifying and treating chronic conditions more quickly and effectively, and improving appropriate medication use and adherence, thus slowing the progression of those diseases.  AMCP recognizes that, as a trained medication management specialist, the pharmacist has clinical expertise and a leadership role to play in the collaborative development, implementation and improvement of disease management programs.

(See AMCP Managed Care Pharmacy Practice Positions – Disease Management)

AMCP supports the use of appropriately designed formularies as quality-enhancing, cost-effective pharmaceutical care tools that meet the needs of the patient population and assist members of the health care team in effectively managing a patient's total medical care regimen. Formulary coverage decisions are based primarily on sound clinical evidence. Cost should be considered only after safety, efficacy and therapeutic need have been assessed. The value of a formulary is maximized when it is part of an integrated patient care process and integrates with other health care management tools, such as drug utilization review and medical treatment guidelines. The overall formulary system encourages physicians, pharmacists, and other care givers to work together to ensure positive outcomes and cost-effective results.

(See AMCP Managed Care Pharmacy Practice Positions - Formularies, and AMCP Concepts in Managed Care Pharmacy - Formulary Management)

AMCP recognizes that pharmacists have a responsibility to the public and to individual patients to promote disease prevention through patient assessment and administration of appropriate immunization to all patients and age groups, especially those at risk. AMCP supports federal and state legislative and regulatory provisions that give pharmacists and qualified staff under the supervision of a pharmacist, in accordance with state law, the authority to administer immunizations. Further, AMCP affirms that schools and colleges of pharmacy should include education and training concerning patient assessment, promotion, and administration of immunizations in their curricula.

AMCP advocates direct involvement of pharmacists in the development, evaluation, and implementation of evidence-based clinical practice guidelines that focus on an interdisciplinary team approach to patient care.

AMCP believes that achieving optimal therapeutic outcomes for each patient is a shared responsibility of the health care team. AMCP further supports the active role of the pharmacist in the development, implementation and monitoring of therapeutic plans, which include provider communication and assisting patients to become informed decision makers to improve adherence with their prescribed therapeutic plan.

Promotion and Certification of Pharmacy-Based Health Management Programs

Policy 0025

02/01/2000 Introduced
02/01/2005 Revised
02/01/2010 Reapproved
04/07/2015 Reapproved
10/29/2019 Revised

AMCP recommends enactment of state pharmacy practice act revisions enabling pharmacists to practice as health care providers and essential members of the patient care team.

Pharmacogenomics

Policy 0107

03/01/2001 Introduced
11/01/2005 Reapproved
11/01/2009 Revised
02/01/2014 Revised
02/21/2018 Reapproved

AMCP supports further research and assessment of the economic, clinical, and humanistic impact of pharmacogenomics on managed care pharmacy practice. AMCP supports the pharmacist's leadership role in the review and evaluation of scientific evidence and the subsequent development of pharmaceutical care processes involving these therapies through collaboration with other health care practitioners and consumer organizations. Pharmacy and Therapeutics Committees in collaboration with Health Technology Assessment committees should be involved in the decision-making process related to coverage of genetic tests and utilization management strategies.

AMCP supports the appropriate access to medications and the development of integrated systems to ensure access to enhanced pharmacy services and pharmaceutical products for all patients, regardless of insurance coverage or income.  

Continuous Quality Improvement

Policy 0301

02/01/2003 Introduced
02/01/2008 Reapproved
10/01/2012 Reapproved
02/21/2018 Revised

AMCP supports the role of utilization management in the provision of quality, cost-effective prescription drug benefits. The fundamental goal of utilization management is to promote the appropriate and cost-effective use of medications. Pharmacists in all practice settings must work collaboratively to develop specific policies and procedures to ensure that the utilization management process is administered in the most efficient manner possible, is fully compliant with statutory and regulatory requirements and provides members, pharmacists and prescribers with an evidence-based, rational process to promote appropriate drug use. Examples of utilization management strategies used within a prescription drug benefit include prior authorization, step therapy, quantity management, drug utilization review (DUR), site of service steerage, and the formulary exception process.

(See AMCP Concepts in Managed Care Pharmacy – Prior Authorization)

Health Care Services Provided by a Pharmacist

(Prior to 7/29/14 revision, titled: Compensation for Pharmaceutical Care Services)
 

Policy 0601

02/01/2006 Introduced
12/01/2010 Revised
07/29/2014 Revised
04/12/2021 Revised

AMCP believes that the pharmacist, as the medication management professional, has the training and expertise to provide health care-related services that improve patient outcomes and reduce health care costs. AMCP encourages pharmacists to lead collaborative efforts in the development and implementation of care plans and participate in collaborative practice agreements. AMCP supports appropriate compensation for health care services provided by pharmacists that demonstrate value to practitioners, patients and payers.  

AMCP recommends that medication therapy management (MTM) programs, including comprehensive medication reviews, be designed based on the needs of identified populations of a plan and delivered through different modalities including face-to-face and via the use of technology. These programs utilize appropriate patient selection criteria and interventions to meet both social and health related needs of the individual members and optimize medication use. Emphasis should be placed on coordination of care for the patient, and integration of MTM programs, disease management and medical management programs, when possible, to effectuate enhanced patient outcomes. MTM programs should identify appropriate outcomes and design measurements to assess the outcomes and maintain appropriate documentation and results. MTM programs should be evaluated and revised on a continuing basis to ensure that quality and value are maintained.

Provider Status for Pharmacists

Policy 1201

06/01/2013 Introduced
03/27/2017 Revised
07/19/2018 Revised
10/22/2018 Revised

The Academy of Managed Care Pharmacy (AMCP) supports the recognition of pharmacists as providers under the Social Security Act. Pharmacists provide measurable improvements in healthcare outcomes and patient satisfaction and reduce overall healthcare expenditures. AMCP strongly believes the formal recognition of pharmacists as health care providers will increase their contribution to address primary healthcare needs, including medication administration, as part of collaborative healthcare with fewer barriers.

(See AMCP Managed Care Pharmacy Practice Positions – Provider Status for Pharmacists)

Medication Synchronization

Policy 1501

02/10/2015 Introduced

The Academy of Managed Care Pharmacy (AMCP) supports the concept of medication synchronization as one tool that may improve adherence.  Prescription drug therapy provides a tremendous value to the overall healthcare system and that value is only realized when medication therapies are taken by patients as prescribed.  AMCP supports continued industry development and rollout of medication synchronization programs and believes that best practices currently being developed will benefit patients and payers.  Therefore AMCP will oppose legislation that mandates medication synchronization and requires a specific government framework as an unnecessary barrier to best practices. 

(See AMCP Where We Stand Position Statement – Medication Synchronization.)

Transitions of Care

Policy 2002

11/17/2020 Introduced