Medication therapy management favors large pharmacy chains and creates potential conflicts of interest

Journal of Managed Care Pharmacy

Volumn 15, Issue 6, 2009, Pages 495-500

  Cook, Daniel M ^a   Mburia Mwalili, Adel ^a  

^a UNIVERSITY OF NEVADA   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CONFLICT OF INTEREST; COST CONTROL; HEALTH CARE COST; HEALTH CARE ORGANIZATION; HEALTH CARE PERSONNEL; HEALTH CARE UTILIZATION; HEALTH INSURANCE; HOSPITALIZATION; MEDICARE; MEDICATION THERAPY MANAGEMENT; NOTE; PHARMACIST; PHARMACY; PRESCRIPTION; REGISTER;

EID: 69249090611     PISSN: 10834087     EISSN: None     Source Type: Journal    
DOI: 10.18553/jmcp.2009.15.6.495     Document Type: Note

References (43)

1. Manasse HR, Jr., Speedie MK. Pharmacists, pharmaceuticals, and policy issues shaping the work force in pharmacy. AmJ Health Syst Pharm. 2007;64(12):e30-48.
2. Gonzalez J, Noga M. Medication therapy management. J Manag Care Pharm. 2008;14(6, suppl S-c):S8-SH. Available at: http://www.amcp.org/ data/jmcp/Aug%20suppl%20C-S8-Sll.pdf.
3. Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Public Law No. 108-173: December 8, 2003. Available at: http.//www. ustreas.gov/offices/public-affairs/hsa/pdf/pll08-173.pdf. Accessed June 16, 2009.
4. lsetts BJ, Buffington DE, Pharmacist Services Technical Advisory Coalition. CPT code-change proposal: national data on pharmacists' medication therapy management services. AmJ Health Syst Pharm. 2007;64(15): 1642-1646
5. Barnett MJ, Frank J, Wehring H, et al. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years. J Manag Care Pharm. 2009;15(1):18-31. Available at: http:// www.amcp.org/data/jmcp/018-031.pdf.
6. Bluml BM. Definition of medication therapy management: development of professionwide consensus. J Am Pharm Assoc (2003). 2005;45(5):566-572
7. Bunting BA, Cranor CW. The Asheville Project: long-term clinical, humanistic, and economic outcomes of a community-based medication therapy management program for asthma. J Am Pharm Assoc (2003). 2006,46(2):133-147
8. Stebbins MR, Kaufman DJ, Lipton HL. The PRICE clinic for low-income elderly: a managed care model for implementing pharmacist-directed services. J Manag Care Pharm. 2005;11(4):333-341 Available at: http://www.amcp. org/data/jmcp/contemporary-333-341.pdf.
9. McLean DL, McAlister FA, Johnson JA, et al. A randomized trial of the effect of community pharmacist and nurse care on improving blood pressure management in patients with diabetes mellitus: study of cardiovascular risk intervention by pharmacists-hypertension (SCRIP-HTN). Arch Intern Med. 2008;168(21):2355-2361
10. Altavela JL, Jones MK, Ritter M. A prospective trial of a clinical pharmacy intervention in a primary care practice in a capitated payment system. J Manag Care Pharm. 2008;14(9):831-843 Available at: http://www amcp.org/ data/jmcp/831-843.pdf.
11. Nieten PJ, Tilley BC, Zhao W, et al. Two pharmacy interventions to improve refill persistence for chronic disease medications: a randomized, controlled trial. Med Care. 2009;47(1):32-40.
12. Thompson CA. National billing codes announced for pharmacists' clinical services. Am J Health Syst Pharm. 2005;62(16):1640-1642
13. Thompson CA. Pharmacists' CPT codes become permanent: next step is to set valuation for each code. Am J Health Syst Pharm. 2007;64(23):2410-2412
14. The Lewin Group. Medication therapy management services: a critical review. J Am Pharm Assoc (2003). 2005;45(5):580-87. Available at: http:// www.accp.com/docs/positions/commentaries/mtms.pdf. Accessed June 16, 2009.
15. KilianJ, Stubbings J. Medicare Part D: Selected issues for pharmacists and beneficiaries in 2007. J Manag Care Pharm. 2007;13(1):59-65. Available at: http://www.amcp.org/data/jmcp/59-65.pdf.
16. Touchette DR, Burns AL, Bough MA, Blackburn JC. Effective Health Care Research Report No. 1: Survey of Medicare Part D Plans' Medication Therapy Management Programs. (Prepared by University of Illinois-Chicago DEcIDE Center Under Contract No. HSA29020050038I.) Rockville MD: Agency for Healthcare Research and Quality; February 2007. Available at: http:// effectivehealthcare. ahrq.gov/repFiles/Medication-Therapy-Management-Programs.pdf. Accessed June 12, 2009.
17. Centers for Medicare & Medicaid Services. Medicare Part D Medication Therapy Management (MTM) Programs: 2008 Fact Sheet. Available at: http://www cms.hhs.gov/PrescriptionDrugCovContra/Downloads/ MTMFactSheet.pdf. Accessed June 12, 2009.
18. Brooks JM, Unni EJ, Klepser DG, Urmie JM, Farris KB, Doucette WR. Factors affecting demand among older adults for medication therapy management services. Res Social Adm Pharm. 2008;4(4):309-319
19. Moczygemba LR, Barner JC, Gabrillo ER, Godley PJ. Development and implementation of a telephone medication therapy management program for Medicare beneficiaries. Am J Health Syst Pharm. 2008;65(17):1655-1660
20. Thompson CA. Minnesota pharmacists use CPT codes. Am J Health Syst Pharm. 2006;63(13):1208,1210.
21. Dole EJ, Murawski MM. Reimbursement for clinical services provided by pharmacists: what are we doing wrong? AmJ Health Syst Pharm. 2007;64(1): 104-106
22. Nutescu EA, Klotz RS. Basic terminology in obtaining reimbursement for pharmacists' cognitive services. Am J Health Syst Pharm. 2007;64(2):186-192
23. Moczygemba LR, Barner JC, Roberson K. Texas pharmacists' opinions about and plans for provision of medication therapy management services. J Am Pharm Assoc (2003). 2008;48(1):38-45.
24. Beatty SJ, Rodis JL, Bellebaum KL, Mehta BH. Community and ambulatory pharmacy: evaluation of patient care services and billing patterns before implementation of Medicare part D. J Am Pharm Assoc (2003). 2006;46(6):707-714
25. Urmie JM, Farris KB, Herbert KE. Pharmacy students' knowledge of the Medicare drug benefit and intention to provide Medicare medication therapy management services. Am J Pharm Educ. 2007;71(3):41.
26. Spooner JJ. A bleak future for independent community pharmacy under Medicare Part D.J Manag Care Pharm. 2008;14(9):878-881 Available at: http://www.amcp org/data/jmcp/878-881.pdf.
27. Carroll NV. Estimating the impact of Medicare Part D on the profitability of independent community pharmacies. J Manag Care Pharm. 2008;14(8):768-779 Available at: http://www.amcp.org/data/jmcp/768-779.pdf.
28. Benner JS, Kocot SL. Medicare Part D: good for patients and an opportunity for pharmacists. J Manag Care Pharm. 2009;15(1):66-70. Available at: http.//www.amcp.org/data/jmcp/066-070.pdf.
29. Sloane T. Another turf war. AMA campaign against retail clinics conflicts with the evidence. Mod Health. 2007;37(28):31.
30. Mehrotra A, Wang MC, Lave JR, Adams JL, McGlynn EA. Retail clinics, primary care physicians, and emergency departments: a comparison of patients'visits. Health Aff (Millwood). 2008;27(5):1272-1282
31. Böhmer R. The rise of in-store clinics - threat or opportunity? N Engl J Med. 2007;356(8):765-768
32. Laws M, Scott MK. The emergence of retail-based clinics in the United States: early observations. Health Aff (Millwood). 2008;27(5):1293-1298
33. Costello D. A checkup for retail medicine. Health Aff (Millwood). 2008;27(5):1299-1303.
34. Author not listed. Airport MD, pharmacies move into U.S. airports. USA Today. April 11, 2008. Available at: http://www.nursinglink.com/news/3185- airport-md-pharmacies-move-into-us-airports. Accessed June 16, 2009.
35. Top 30 Retail Pharmacy Chains. Drug Store News. August 22, 2005. Available at: http://findarticles.eom/p/articles/mi-m3374/is-10-27/ai-nl5341413. Accessed June 16, 2009.
36. Cipher DJ, Hooker RS, Guerra P. Prescribing trends by nurse practitioners and physician assistants in the United States. J Am Acad Nurse Pract. 2006;18(6):291-296
37. Hoffer GE. Physician-ownership in pharmacies and drug repackagers. Inquiry. 1975;12(1):26-36.
38. Manchikanti L, McMahon EB. Physician refer thyself: is Stark II, phase III the final voyage? Pain Physician. 2007;10(6):725-741
39. Wilson CN. Physician-owned pharmacies under attack. Hosp Pharm. 1990;25(3):273-276
40. Mitchell JM. The prevalence of physician self-referral arrangements after Stark II: evidence from advanced diagnostic imaging. Health Aff (Millwood). 2007;26(3):w415-w424.
41. Becker S, Lundeen R, Heinze G. CMS issues final Phase III Regulations - significant impact on physician-hospital and physician-driven relationships. Health Care Law Mon. 2007;2007(12):2-19.
42. Nystrom JS. Time to respond to in-store clinics. JAm Osteopath Assoc. 2008;108(2):52-53.
43. Department of Health and Human Services, Centers for Medicare & Medicaid Services. Medicare Program; Medicare Part D Claims Data; Final Rule. In: Centers for Medicare & Medicaid Services, ed. 42 CFR Part 423. Federal Register: NARA; 2008. Available at: http.//www.cms.hhs.gov/ PrescriptionDrugCovGenln/Downloads/PartDDataReg.pdf. Accessed June 16, 2009.