Cost-Effectiveness of Medication Therapy Management Program Across Racial and Ethnic Groups Among Medicare Beneficiaries

Tsang, Chi Chun Steve; Shih, Ya-Chen Tina; Dong, Xiaobei; Garuccio, Joseph; Browning, Jamie A.; Wan, Jim Y.; Chisholm-Burns, Marie A.; Dagogo‐Jack, Samuel; Cushman, William C.; Zeng, Rose; Wang, Junling

doi:10.1016/j.jval.2022.09.2480

Cited by 4 publications

(6 citation statements)

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“…In contrast, a prior study reported that MTM provided higher net benefits in managing medication utilization for Black patients than for White patients. [ 11 ] The differences in research design and empirical approach may account for some of the discrepancies in findings between the current and prior study. The previous study was a conventional cross-sectional CEA using 2017 Medicare data, where the MTM sample consisted of predominantly beneficiaries who continued MTM from the previous year.…”

Section: Discussionmentioning

confidence: 84%

“…[36] The current finding suggests that MTM can be a cost-effective solution to achieve these objectives, at least in the short run, corroborating earlier studies on positive effects of MTM. [7][8][9][10][11] The current study found no substantial empirical evidence that MTM was associated with increased incremental net benefit among racial/ethnic minorities than White patients. In contrast, a prior study reported that MTM provided higher net benefits in managing medication utilization for Black patients than for White patients.…”

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

“…[7–10] A recent study also indicated that MTM services are cost-effective in managing medication utilization issues compared to standard Medicare services. [11] This underscores the importance of MTM programs in improving health outcomes for older adults and reducing the financial burden of inappropriate medication utilization on the healthcare system.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study provides evidence that MTM services may be a more cost-effective approach to enhancing the medication utilization quality for Black patients with various chronic conditions. [ 11 ] This suggests that MTM may hold promise as a strategy for reducing racial and ethnic disparities in health outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Cost-effectiveness of medication therapy management among Medicare population and across racial/ethnic groups

Tsang,

Wang,

Shih

2024

Medicine

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Background: Inappropriate medication utilization among older adults is a pressing concern in the United States, owing to its high prevalence and the consequential detrimental impact it engenders. The adverse effects stemming from the inappropriate use of medication may be unequally borne by racial/ethnic minority populations, calling for greater efforts towards promoting equity in healthcare. The study objective was to assess the cost-effectiveness of Medication Therapy Management (MTM) services among Medicare beneficiaries and across racial/ethnic groups. Methods: Medicare administrative data from 2016 to 2017 linked to Area Health Resources Files were used to analyze Medicare fee-for-service patients aged 65 or above with continuous Parts A/B/D coverage. The intervention group included new MTM enrollees in 2017; the control group referred to patients who met the general MTM eligible criteria but did not enroll in 2016 or 2017. The 2 groups were matched using a propensity score method. Effectiveness was evaluated as the proportion of appropriate medication utilization based on performance measures developed by the Pharmacy Quality Alliance. Costs were computed as total healthcare costs from Medicare perspective. A multivariable net benefit regressions with a classic linear model and Bayesian analysis were utilized. Net benefit was calculated based on willingness-to-pay thresholds at various multiples of the gross domestic product in 2017. Three-way interaction terms among dummy variables for MTM enrollment, 2017, and racial/ethnic minority groups were incorporated in a difference-in-differences study design. Results: After adjusting for patient characteristics, the findings indicate that MTM receipt was associated with incremental net benefit among each race and ethnicity. For instance, the net benefit of MTM among the non-Hispanic White patients was $2498 (95% confidence interval = $1609, $3386) at a willingness-to-pay value of $59,908. The study found no significant difference in net benefits for MTM services between minority and White patients. Conclusion: The study provides evidence that MTM is a cost-effective tool for managing medication utilization among the Medicare population. However, MTM may not be cost-effective in reducing racial/ethnic disparities in medication utilization in the short term. Further research is needed to understand the long-term cost-effectiveness of MTM on racial/ethnic disparities.

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Section: Discussionmentioning

confidence: 84%