A look at the important work of the Medication Therapy Management Clinics at Methodist Dallas
If a few pills could save your life, would you take them? For most, the answer is a resounding “Yes.” Yet a surprising 50 percent of patients with chronic diseases don’t take their medications as prescribed, according to a review in Annals of Internal Medicine. Fear of side effects, high costs, and misunderstanding, are among the reasons patients don’t take their medicine — and the results can be tragic. Nonadherence causes approximately 125,000 deaths and 10 percent of hospitalizations each year — not to mention up to $289 billion in annual costs to the U.S. healthcare system.
The new Medication Therapy Management (MTM) clinics at Methodist Dallas Medical Center are working to make it easier for patients with chronic diseases to access the life-changing medications they need. Working with patients, insurance providers, and physicians, the clinics help patients avoid potential medication conflicts, manage side effects and other health issues, and ensure patients take medications correctly to get the best outcomes possible.
Curing hepatitis C since 2015
Five million Americans have hepatitis C. Left untreated, the virus leads to kidney damage, liver cancer, and (without a liver transplant) death. Until recently, there was no cure. Early treatments were only effective about half the time, and many patients were excluded due to coexisting conditions or side effects. However, in 2013, everything changed. Newer, more effective treatments became available for all patient groups, including people with HIV, cardiovascular disease, and transplants, with fewer side effects and cure rates of about 95 percent.
In June 2015, Methodist Dallas created the first MTM Clinic to help patients with hepatitis C access this lifesaving care. The clinic has treated about 800 patients since, with a cure rate of 97 percent — two points higher than the national average. Parvez Mantry, MD, transplant hepatologist on the medical staff at The Liver Institute at Methodist Dallas, helped spearhead the program.
“We have critical therapies. We have a large population,” Dr. Mantry says. “We felt that if we had a dedicated platform for integrated delivery of care, we could have a tremendous impact on the health of the community. Our biggest success is that we have not had any patients for whom we have not been able to provide drug therapy for viral hepatitis. In terms of coverage, there are no patients left behind.”
Removing barriers to life-changing care
Patients with chronic conditions like hepatitis C require therapy that is complex, expensive, and not easily accessible. The drugs aren’t sold at retail pharmacies, and require preauthorization from third-party payers. Successful treatment also requires dedicated pharmacists who can help patients navigate drug interactions and ensure compliance. MTM pharmacists work with patients, insurance providers, and physicians from the very beginning.
“We spend a lot of time talking with insurance companies; if a patient is denied access, we appeal it on their behalf to ensure they get the medication they need,” says Melanie Proffitt, PharmD, BCACP, clinical pharmacist for the MTM Clinic. “We also follow up with pharmacies if patients run out of medications, because it’s not something you can start and stop. Our pharmacists have pagers and are on call 24/7. We want to make sure patients know they always have someone to talk to.”
Also helping to make these medications more accessible is participation in the federal 340B Drug Therapy Program, which provides drugs at a discount to patients. Patients at the MTM Clinic also have access to a hepatitis C navigator, who helps facilitate care and connect patients to drug discount programs.
Improving outcomes for patients with complex treatment issues
Patients with multiple health conditions are often denied medication coverage because of interactions with other medications. The MTM Clinic specializes in helping patients like these get the care they need.
For example, one patient with a seizure disorder had been denied coverage for hepatitis C medications because of drug interactions listed in the package insert. MTM pharmacists sat down with the patient, primary care provider, and The Liver Institute team to put together a plan and worked with the insurance company, who agreed to provide coverage if the pharmacy provided monitoring. The patient was cured of hepatitis C without a single seizure.
Another patient was in need of a heart transplant but could not be placed on a list because of his hepatitis C status. The MTM clinic successfully cured the patient while monitoring potential interactions with cardiac medications, with no incidents.
A second chance at life
Josephine Miree-Dumas knows the value of the program firsthand. She was diagnosed with hepatitis C in 2001, but had previously discontinued treatment because of anemia. Fortunately, she resumed treatment at The Liver Institute in 2015 — and was cured in just one month. Today she is doing well and grateful for what she considers a second chance at life.
“I have 16 grandchildren and 10 great-grandchildren, whom I now get to play with, go to the park with, and do things that I would not be able to do had I not been cured,” Josephine says. “I am so thankful. God bless the donors who support this program — they are saving lives.”
Expanding the program more patients
Following the success of the first MTM Clinic at The Liver Institute, Methodist Dallas opened a second MTM Clinic for cardiology, which has treated between 200 and 300 patients. In June, Methodist opened a third MTM Clinic to treat patients with HIV. Jon Albrecht, vice president of operations at Methodist Dallas, would like to see the program expand even more.
“It’s important for patients with chronic conditions to be able to access the therapies they need,” Albrecht says. “Right now, we are focusing on high-cost, high-complexity drug therapies. If we had more support, we could expand clinics to better treat patients with other chronic conditions, like diabetes and asthma.”
Donors make it possible
The MTM Clinics help patients get better, live longer, and fully recover from chronic diseases. With support from the Foundation, the program could open more facilities, see more patients, and make healthcare affordable for even more people.
Want to help? Be a part of bringing this lifesaving service to people with chronic illness.