chapter12 ppt 10 4 2017 doing

CHAPTER 12

PHARMACY
SERVICES


*OBJECTS:
• Discuss the history and the development of research on the
value of pharmacy services
• List issues specifically related to critiquing pharmacy service
research.
• Understand the importance of measuring costs and patient
outcomes associated with medication therapy management
(MTM) services mandated for high-risk Medicare patients.
• Critique an example of a pharmaco-economic study that
evaluates pharmacy services


Definition about pharmacy services
History of pharmacy services
Review of the research

CONTENTS

Issues in valuing pharmacy services

Medicare medication therapy

Summary

Pharmacy services

DEFINITION
Identifies, measures, and compares the costs and
consequences of pharmaceutical products and services
clinical pharmacy services
A variety of terms
have associated with
pharmaceutical or
pharmacy services

pharmaceutical care services
cognitive pharmacy services
disease-state management
medication therapy management (MTM)


Pharmacy services

HISTORY OF PHARMACY SERVICES
Research articles estimating the value of pharmacy
1970s
services have been published.
1971
1971

Evaluate the effects of pharmacy services, by the Task
Force on the Pharmacist’s Clinical Role.

1990

Helper and Strand4 proposed the concept that
pharmacist should provide pharmaceutical care.

2006

The federal government has recognized the importance
of MTM services and included the provision of these
services to high-risk patients as part of the Medicare Part
D outpatient prescription drug benefit that took effect.


Pharmacy services

REVIEW OF THE RESEARCH
How is a value placed on pharmacy services?

Using a variety of approaches

Contingent
valuation
(CV)

Prospective
studies

Modeling

Combination of
these methods

Pharmacy services

The IMPROVE Study

Specific Multipharmacy Projects

The Asheville Project

The Patient Self-Management
Program


Pharmacy services

ISSUES IN VALUING PHARMACY SERVICES
Wide Variation in Services
Type of Pharmcoeconomic Study
The Asheville Project

Costs Associated with Providing Services
Benefits Associated with Services
Pharmacy Budget Silo Mentality


Pharmacy services

MEDICARE MEDICATION THERAPY MANAGEMENT

Medication therapy review
A personal medication record

MTM

A medication action plan
Intervention and referral
Documentation and follow-up


Pharmacy services

MEDICARE MEDICATION THERAPY MANAGEMENT
2003
2005
2006
2008

2010

• Etermad and Hav used information from past literature to create a Markov model
to predict the cost per life year saved because of MTM services
• Oladapo et al. conducted a literature search for studies on clinical pharmacy
services (including MTM services) with results reported in term of cost-benefit
ratios, net benefits/savings, return on investment, cost savings or cost avoided
• Touchette et al. surveyed MTM programs to determine what had been
implemented in the first 4 months of the program
• Some updates (Version 2.0) version places an increased emphasis on the
patient’s role in medication self-management, care transitioning and
collaborative health care team partnerships.

• A preliminary study by CMS retrospectively investigated how enrollment in a
standalone Prescription Drug Plan (PDP) or Medicare Advantage Prescription
Drug Plan (MAPD) MTM program with or without receipt of an annual
comprehensive medication review (CMR) influenced drug therapy, resource
utilization, and cost for a 6-month period


Pharmacy services

Describing and evaluating the
provision of nondispensing
clinically based pharmacy
services has appeared in the
literature since the 1970s.

SUMMARY

The results of three
prospective multipharmacy
studies-the IMPROVE study,
the Asheville Project, and the
PSMP program
The Medicare Modernization
Act (MMA) created an
outpatient prescription drug
benefit that was implemented
in January of 2006


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