Medication Therapy Management (MTM)

Medication therapy management is a service where a pharmacist sits down with a patient, usually by phone or in person, and goes through every medication they take: prescriptions from every doctor, over-the-counter drugs, vitamins, and supplements. The pharmacist looks for drugs that interact, drugs that duplicate each other, drugs the patient is no longer taking or taking wrong, and cheaper options in the same class. The patient leaves with a written list and an action plan, and the pharmacist sends notes to the prescribers.

Medicare Part D plans are required to offer MTM to members with several chronic conditions and high drug costs, and the numbers behind that rule are worth knowing. Adults over 65 take an average of four or more prescriptions, roughly a third take five or more, and adverse drug events send about 1.3 million Americans to the emergency room every year. In commercial plans, MTM is optional and is usually offered through the PBM or a pharmacy chain for members with a defined number of maintenance drugs. The reviews I have seen done well found something on most patients: two blood pressure drugs from two doctors, a brand drug with a $4 generic twin, a supplement that was blunting a blood thinner.

The takeaway: if you or a family member take five or more medications, ask your pharmacy for a comprehensive medication review. Many plans pay for it, and even at retail it is one of the cheapest hours of healthcare you will ever buy.