Ultimately, MTM programs translate into better health outcomes, which can enable the senior population to live longer, healthier
lives. "MMA will ultimately increase access to medications," says William Simonson, chairman of the Commission for Certification
in Geriatric Pharmacy. "However, throwing a trillion dollars worth of medications at seniors may be doing them a tremendous
disservice if the drug therapy is not properly monitored. The older population is extremely vulnerable to medication-related
problems. If seniors gain access without proper education and controls, we could face an unimaginable epidemic of polypharmacy."
Polypharmacy, or use of multiple medications, has the potential to induce drug interactions that adversely affect seniors.
The Elderly Consume More Medicine
Data show that the number of Medicare enrollees afflicted with multiple chronic conditions is extremely high. "When you look
at an elderly patient's profile, they may be on 10 scripts per month for maintenance of chronic conditions," says Melinda
Odom, senior clinical pharmacist with CarePlus Health Plans. In fact, the Academy of Managed Care Pharmacy states that approximately
80 percent of Medicare-eligible seniors have multiple chronic conditions and about 20 percent of Medicare beneficiaries have
five or more chronic conditions. More than two-thirds of Medicare spending goes toward the latter population.
MTM programs are specifically designed to prevent these negative outcomes and keep seniors on track with their drug regimes.
By calling for medication treatment plans, regular drug reviews, therapy-response monitoring, verbal education and training,
and support services for patients, these programs can increase adherence and decrease adverse drug events among the Medicare
Demand for Geriatric Specialists
While many Medicare plans have not publicly announced the details of their MTM programs, pharmacists are expected to play
a crucial role in their implementation. "With the new Medicare guidelines, there is a huge opportunity for geriatric pharmacists
and the specialized expertise they bring to the table," says Chitre. She says there will be a push to work with pharmacists
who have expertise in geriatrics to help create better health outcomes, maximize efficiencies in drug therapy, and identify
"I've seen so many situations where problems were caused by drug therapy," says Simonson. "So many times these negative outcomes
were entirely preventable. By participating in the coordination of drug therapies of elderly patients, geriatric pharmacists
play the role of risk managers—for both patients and physicians."
Certified Geriatric Pharmacists
In addition to MTM programs, CMS provides guidance to Medicare plans by providing geriatric-specific insight for the formulary
design process. CMS mandates that Medicare plans have a P&T Committee including at least one practicing pharmacist or physician
who specializes in care for the elderly or disabled. Specifically, P&T committees will now have to focus on products unique
to the senior population, such as medications for Alzheimer's disease.
"The new Medicare prescription-drug benefit and medication-therapy management programs are a whole new frontier for pharmacists,"
says Chitre. "We need to be educated on how to treat patients, lower costs, and decrease side effects in the elderly population."
Marketing to Senior Specialists
Pharma companies that specialize in marketing products to the senior population are starting to recognize senior-care specialists
as an influential new group within the managed care arena. "We are monitoring trends in geriatric pharmacy and are looking
to create early partnerships with organizations seeking to improve pharmacy care for the elderly," says Tom Koenig, senior
director of segment marketing for Endo Pharmaceuticals.