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Public and private payers seemingly intent on wringing the last bit of profit from drug distribution have forced pharmacy to a "critical juncture," according to Bruce Roberts, R.Ph., executive VP/CEO, National Community Pharmacists Association. He believes that if the profession is going to survive, let alone thrive, it must erect a new model built around paying pharmacists for providing face-to-face medication therapy management (MTM) services.
The current pharmacy business model of making money from selling drugs "may be on life support," said John Coster, R.Ph., Ph.D., VP of policy and programs, National Association of Chain Drug Stores. "We must look for other ways to sustain the practice, and MTM is the future. It's just that the bottom line is, 'Show me the money.' Pharmacists are highly trained professionals, but right now the model pays them to fill, it doesn't pay them to provide MTM services. That's why it's so important to convince payers-private and public-of the value of these services and to pay for them."
More public and private payers are willing to listen to the MTM story, according to pharmacy leaders. Even as new programs are now being routinely announced, organizations have been working in three areas to build critical infrastructure that will support MTM services: billing codes specific to MTM, quality measures, and a common on-line platform to document and bill for MTM services regardless of the individual program.