[Congressional Record Volume 157, Number 16 (Thursday, February 3, 2011)]
[Senate]
[Pages S546-S547]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. HAGAN (for herself, Mr. Franken, Mr. Brown of Ohio, and 
        Mr. Johnson of South Dakota):
  S. 274. 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 reintroduce the 
Medication Therapy Management, MTM, Empowerment Act of 2011, with my 
colleagues from Minnesota, Senator Franken, from Ohio, Senator Brown, 
and from South Dakota, Senator Johnson.
  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 referenced 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

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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 one and a $6,502 decrease in year five; 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. A total of 31,000 seniors have participated since 2007. 
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 
has saved an estimated $34 million to date, and countless health 
problems have been 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 reintroducing 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 requires that 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 collegues to support this bill.
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