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By Terry McInnis, MD, MPH, President and Co-Founder, Get the Medications Right Institute

July 24, 2019

We spent roughly $480 billion for prescription drugs in 2016. That same year, we wasted $528 billion on non-optimized medication use.

Why? The reasons are complex.

First, we lack a systematic, coordinated approach to medication management that can ensure medications are appropriately and effectively used.

Second, we are in the midst of the greatest evolution in health care, a transition from population health-based clinical guidelines to personalized precision medicine. One person’s hypertension, depression, diabetes or cancer does not respond consistently to the same milieu of drugs, even when guidelines are strictly followed and patients 100% compliant. Also, we miss many people at high risk for developing disease and overtreat many at lower risk. Whole genome sequencing reveals new mutations and is allowing ever greater precision. Advances in pharmacogenomics, diagnostics, targeted therapies and even microbiome influences are turning our understanding of drug and genetic therapy from a shot gun approach to—one day—laser certainty.

Third, policy and payments must align with these scientific and delivery system realities if we are to close the gap between scientific discovery and direct patient care.

That’s why we launched the Get the Medications Right (GTMRx) Institute in March 2019 with a specific, crosscutting—and, I believe, unique—focus: Bring critical stakeholders together, bound by the urgent need to optimize outcomes and reduce costs by getting the medications right.

Already more than 200 members strong, these stakeholders must come from both the practice delivery side—to include the unique and vastly underutilized services of clinical pharmacists and genetic counselors—as well as the IT and analytics/AI enablement, advanced diagnostics integration, and policy and payment spheres, all working with patients to transform care.

Our goal is to attack the issue of non-optimized medication use. We’re engaging physicians, clinical pharmacists and other members of the care team to transform practice and integrate comprehensive medication management (CMM) as the means by which to focus on this personalized, precision approach to medication management . We’re boosting evidence while informing payers and policymakers about CMM’s promise to lower costs and improve lives when we have the IT integration, analytics and advanced diagnostics with outcomes at our fingertips—at the point of care.

Understanding CMM

Let me back up for a second and answer two key questions: What is CMM, and why do we believe it will optimize clinical outcomes?

It’s a systematic approach to medications where physicians and pharmacists ensure that medications (whether they are prescription, nonprescription, alternative, traditional, vitamins, or nutritional supplements) are individually assessed to determine that each medication is appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications being taken, and able to be taken by the patient as intended.

CMM optimizes medical outcomes by ensuring medications are appropriately and effectively used. This not only boosts cost-effectiveness; it assures that all conditions are effectively managed, building the bridge from uncoordinated “trial-and-error,” population-based medication use to personalized, science-and-data-driven medication therapy.

It’s important to distinguish between CMM and other forms of medication therapy management (MTM).

CMM is patient-centric, based on optimizing the clinical goals of therapy, and was defined by the Patient-Centered Primary Care Collaborative.

Many organizations have taken to calling what they do “comprehensive medication management.” They may do two or three components, but no more. That’s like having one wing and a cockpit and calling it an airplane. To soar, we need the whole bird.

CMM includes 10 specific elements. An organization must do all 10; otherwise, it isn’t providing COMPREHENSIVE medication management.

Dr. Toby Cosgrove, former CEO and executive advisor for Cleveland Clinic, recently said  that medical knowledge is doubling every 73 days. With medications representing 80-85% of the means by which we prevent and treat disease, we must focus on optimizing medications.

It’s time to get the medications right. Join us.

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