Developing Medication Therapy Management Services
Professor Brian Isetts is a national expert in studying the outcomes of medication therapy management (MTM) services.
Since 1992, Minnesota has led the development of MTM services provided within the practice of pharmaceutical care. In the early 1990s, Isetts and others worked collaboratively with key groups in the state including payers, employers, the Minnesota Health Action Group, businesses and legislators. State legislators drafted a bill in support of MTM services, and the legislation passed after five sessions when the Department of Administration advanced a fiscal note supporting cost savings of MTM services.
In 1999 Isetts was recognized for creating the University’s student-driven Pharmaceutical Care Experiential Clinic, which offered MTM services to patients under his direction. It was just the beginning of the college’s leadership in MTM.
“Minnesota built comprehensive medication management practices and today’s students expect that the health care system will be more patient-centered,” said Isetts, who also served as a Health Policy Fellow at the Centers for Medicare and Medicaid Services in Washington, D.C.
“Pharmacists will play a key role as technology unfolds. The college continues to lead in this area, including the promising field of pharmacogenomics.”
Minnesota’s leadership in MTM has opened many doors at the national level.
“Our health care system in Minnesota is very advanced compared to many other states, and a centerpiece of that is our shared services agreements—shared savings contracts with commercial payers,” explained Isetts. “We already have experience with this approach called accountable care organizations at the national level.”
To demonstrate the importance of comprehensive medication management and its role in health care reform, Isetts notes that the U.S. spends more than $400 billion each year on prescription drugs, approximately 15 percent of total U.S. health care expenditures. Each year, the U.S. spends approximately the same amount on drug-related morbidity and mortality.
“Our most common drug therapy problems are patients needing additional drug therapy, and taking too low of a dose,” explained Isetts. “When we fix those problems, the cost of prescription drugs may actually go up initially, but the total costs of care and drug-related morbidity and mortality will decrease significantly. As a mentor once told me, the most expensive medicine is the one the patient is unable to take.”