Economic Impact of a Pharmacy Resident in an Assisted Living Facility—Based Medication Therapy Management Program

Abstract

Pharmacists now have the opportunity to be reimbursed for providing medication therapy management (MTM) services. With 5% of the elderly population living in senior housing such as assisted living facilities, MTM programs need to be evaluated in this setting. To evaluate the economic impact of a postgraduate year 1 (PGY1) pharmacy practice resident's interventions while performing MTM in an assisted living facility. We conducted a prospective, evaluative study at an assisted living facility over 184 days. Patients included in the study were aged 57-100 years. MTM visits were performed by the PGY1 resident, based on the American Pharmacists Association consensus definition of the model of MTM services. The pharmacy resident prospectively collected data, including interventions made and patient demographics. Drug therapy recommendations were categorized and assessed for cost savings and acceptance by a primary care provider. Fifty-three patients were enrolled in the study (mean age 85.3 y). Patients were taking an average of 12 medications (prescription and nonprescription). The pharmacy resident made 125 recommendations to primary care providers; 72 of those were addressed and 90.3% of addressed recommendations were accepted. The largest category to elicit drug therapy recommendations was dose appropriateness. Of the 72 addressed recommendations, 17 (23.6%) resulted in direct cost savings totaling $3774. Costs that accrued as a result of drug therapy recommendations totaled $693. The resultant net cost-benefit was $1550, with a benefit-to-cost ratio of 1.7 and a return on investment of 70%. Our study demonstrates the positive value that a PGY1 pharmacy resident has on an assisted living-based MTM program, with respect to a positive drug-related cost-benefit and drug therapy recommendation acceptance.