[Congressional Record Volume 156, Number 99 (Tuesday, June 29, 2010)]
[Senate]
[Pages S5539-S5540]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
By Mrs. HAGAN (for herself and Mr. Franken):
S. 3543. A bill to amend title XVIII of the Social Security Act to
expand access to medication therapy management services under the
Medicare prescription drug program; to the Committee on Finance.
Mrs. HAGAN. Mr. President, today, I am proud to introduce the
Medication Therapy Management, MTM, Expanded Benefits Act of 2010, with
my colleague from Minnesota, Senator Franken.
A recent analysis conducted by the New England Healthcare Institute
estimates that the overall cost of medication nonadherence is as much
as $290 billion per year. According to a recent article published in
the New England Journal of Medicine, over $100 billion is spent
annually on avoidable hospitalizations because patients do not take
their medications correctly.
Not only does nonadherence cost our system billions of dollars,
nonadherence to medication regimens also affects the quality of life
for seniors and may lead to early death. The elderly typically take
many more prescription medicines than the general population and
therefore are at greater risk for problems associated with improper use
of medications. For example, the same New England Journal of Medicine
article I just reference found that better adherence to
antihypertensive treatment alone could prevent 89,000 premature deaths
in the U.S. annually.
With as much as one half of all patients in the U.S. not following
their doctors' orders regarding their medications, medication therapy
management could help reduce some of the wasted health care costs in
our system.
North Carolina has implemented some very successful MTM programs.
The Asheville Project, which focuses on diabetes, asthma, and
cardiovascular disease, has seen improved health outcomes and
significant savings among city employees since it began in 1997. For
example, in the Asheville Project's diabetes MTM Project, they have
seen a decrease in medical costs of between $1,622 to $3,356 per
patient per year; a decrease in insurance claims of $2,704 per patient
in year 1 and a $6,502 decrease in year 5; a 50 percent decrease in use
of sick days; and increased productivity gains estimated at $18,000
annually.
In 2007, the North Carolina Health and Wellness Trust Fund Commission
launched an innovative statewide program, Checkmeds NC, to provide MTM
services to North Carolina seniors. During the program's first year,
more than 15,000 North Carolina seniors and 285 pharmacists
participated. The seniors bring all of their prescriptions, over-the-
counter medicines, vitamins and supplements to the pharmacy to be
thoroughly reviewed in a one-on-one session. The pharmacist follows up
and educates the patient about his or her medication regimen. The
program saved an estimated $10 million, and countless health problems
were avoided.
During consideration of health care reform, I was pleased to have
successfully secured language in the bill that built off these North
Carolina models and implemented MTM nationally for seniors suffering
from two or more chronic conditions.
The bill I am introducing today takes MTM one step further.
Specifically, this bill would expand MTM eligibility to seniors with
any chronic condition that accounts for high spending in our health
care system, such as heart failure and diabetes. Currently, only 12.9
percent of Part D beneficiaries are eligible under the MTM criteria for
multiple chronic conditions. However, of those, more than 85 percent
have chosen to participate in the benefit. Clearly this program is very
popular and widely utilized by those who are already eligible. By
expanding eligibility to more seniors, MTM will certainly result in
Medicare savings.
The bill also ensures access to MTM for seniors at a pharmacy or with
a qualified health care provider of their choice.
To ensure pharmacists and health care providers are able to provide
MTM to seniors, this bill ensures they are appropriately reimbursed for
their time and service. This provision will permit pharmacies and other
health care providers to spend considerable time and resources
evaluating a person's drug routine and educating them on proper usage--
all critical components of a successful MTM program.
Finally, this bill would establish standards for data collection to
evaluate and improve the Part D MTM benefit.
The value of MTM is widely known and discussed. I am proud that North
Carolina is a leader in this arena. Expansion of MTM to more seniors
will no doubt improve their overall health, while at the same time
reducing waste in our health care system.
I urge my colleagues to support this bill.
Mr. FRANKEN. Mr. President, I am proud today to be joining Senator
Hagan in introducing the MTM Expanded Benefits Act.
We all know that prescription drugs are an essential part of health
care. What a lot of people don't know is that only about 50 percent of
Americans typically take their medicines as prescribed. This means that
too often, the benefits of these important therapies aren't fully
realized. According to a recent article in the New England Journal of
Medicine, over $100 billion is spent annually on avoidable
hospitalizations because patients don't take their medications
correctly.
The MTM Expanded Benefits Act would help improve the care for seniors
by increasing access to the medication therapy management benefit--also
known as MTM--in the Medicare Part D prescription drug program.
Medication therapy management is a proven set of services that helps
patients get the best possible results from their medications. MTM
services are provided by pharmacists who work with patients and their
health care providers to make sure that seniors are taking medications
as they should be. Through MTM, patients get focused education to make
sure they understand their medications--what conditions the drugs treat
and how to avoid drug interactions that can make medications less
effective or even dangerous.
It is not uncommon for a Minnesota senior who has diabetes to be
taking 10 or more medications that are prescribed by multiple
providers. But right now under Medicare, you would have to have at
least four chronic conditions before you would become eligible for MTM.
That just doesn't make sense to me.
Under the MTM Expanded Benefits Act, seniors with any chronic
condition could benefit from MTM. The bill would increase the number of
people eligible for MTM, helping more seniors to access the life saving
and money-saving services.
Congress recognized the value of MTM when it required Medicare Part D
drug plans to offer the service as part of the Medicare Modernization
Act of 2003. Furthermore, State Medicaid Programs, including ours in
Minnesota, use MTM to maximize the value of their pharmacy benefits. As
we reform our health care system and provide insurance coverage to more
Americans, it makes sense to ensure that MTM becomes more widely
adopted throughout our health care system.
And MTM isn't just good for patient health, it also saves money. A
University of Minnesota study showed that when patients were able to
consult with a pharmacist to determine their optimal medication
regimen, total health expenditures decreased from $11,965 to $8,197 per
patient. The reduction in total health expenditures exceeded the cost
of providing MTM services by more than 12 to 1. That is huge.
[[Page S5540]]
The elderly typically take many more prescription medicines than the
general population and therefore are at greater risk for problems
associated with improper use of medications. Improving the Medicare MTM
benefit will help our Nation's seniors get the most out of their
medications while also helping to reduce costs through appropriate
medication use and improved outcomes. I urge my colleagues to support
the MTM Expanded Benefits Act and help support efforts to improve the
prescription drug benefit for Medicare beneficiaries.
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