Part D protesters and MTM highlight APhA show

April 17, 2006

Brandishing signs and chanting slogans, protesters gathered on the steps of the San Francisco convention center to urge the American Pharmacists Association to take a stand against the Medicare drug plan. Meanwhile, inside the convention hall, APhA conference attendees got the bad news that only 5% of Part D plans are using any community-based providers for medication therapy management (MTM) programs.

Backed by the Gray Panthers, Senior Action Network, and California Alliance for Retired Americans, the anti-Part D demonstrators praised pharmacists as heroes for giving patients medications and cutting through Rx plan red tape. But they also called on APhA to take a stand for changing Part D.

In response, Susan Winckler, R.Ph., Esq., VP of policy and communications at APhA, said that it's time for seniors and pharmacists to join together to make Medicare Part D work. While Part D is not perfect, it's better than no benefit at all. In a prepared statement, APhA said, "We need a simpler program where seniors have choice but not confusion; a program where seniors know what medications and pharmacist services are covered and when; and a program that Medicare controls more closely."

"I'm sure many in the audience would like to see 100% [pharmacist providers], but considering that drug plans are designing their MTM programs, I think it is significant that 5% have elected to use community-based staff," Ketcham said.

Although there were 553 contracts, there may not be that many separate MTM programs as some plans may be using the same third-party providers, including pharmacy benefit managers, MTM companies, and disease state management firms, Ketcham said. The patient interventions are wide-ranging, including letters, refill reminders, counseling and education, or nurse or pharmacist outreach.

Since Medicare beneficiaries are still enrolling and drug plans are still trying to identify patients who qualify for MTM services, CMS does not expect the programs to get off to a rapid start in 2006, according to Ketcham. This year is rather a baseline for MTM services, but 2006 outcomes data won't be available until late 2007 or 2008. CMS doesn't know what would be an ideal MTM program or even if there is one, she added.

In other action at the annual meeting, the APhA house of delegates adopted a slate of resolutions, including the following items: