Medication Therapy Management

How does UPMC for Life help make sure I’m safe on my prescription medications?

One of UPMC for Life's main goals when creating our drug formulary (the list of medications we cover) is to keep our members safe.

An important way we keep members safe is through our drug utilization review.

We have gathered data over the years, and that data now helps us recognize harmful drug-drug interactions. We have safeguards built right into our pharmacy system that reduce the chances of our members experiencing a harmful drug interaction.

UPMC for Life will send an electronic warning to your pharmacist if the pharmacist tries to fill a prescription for a drug that could interact adversely with another medication that you are already taking. This service has been available to our members for some time, and it is constantly reviewed as new drugs come to market and as new, potentially harmful drug combinations are discovered.

Drug utilization is also reviewed after prescriptions for medications have been filled. Our clinical pharmacy team reviews, reports, and identifies members who are at risk for adverse drug events. The team will contact a member’s doctor to discuss potential problems uncovered during the review.

Another way to practice safe medication use is remembering to dispose of any unused or expired medications.

We value your safety and that of those around you. Unused or expired prescription medications are a public safety issue. Proper disposal of unused drugs saves lives and protects the environment. Unused medications should be disposed of as soon as possible using one of the following methods:

• Community take-back sites are the preferred method of disposing of unused controlled substances. Locate a take-back site in your community.
• The U.S. Drug Enforcement Administration (DEA) allows unused prescription medications to be mailed back to pharmacies and other authorized sites using packages made available at such locations. Check with your local pharmacy to see if they are a participating site.
• At-home disposal is an option if you cannot get to a drug take-back location promptly or there is none near you.
  • If your medicine is on the FDA flush list, you can immediately flush these potentially dangerous medicines down the toilet. Find out if your medication is on the FDA flush list by visiting the Disposal of Unused Medicines resource or check the label or the patient information leaflet with your medicine.
  • If your medicine is not on the flush list, you should follow these instructions to discard the medicine in your trash at home:
    • Conceal or remove any personal information, including Rx number, on any empty medication containers.
    • Mix the drugs with an undesirable substance such as dirt or used coffee grounds, place the mixture in a sealed container, such as an empty margarine tub, and discard in the trash.
• Drug deactivation kits for in-home disposal of unused medications may be available in your community. Ask your local pharmacist for more information.

Additional information can be found at the following websites:

• U.S. Department of Health and Human Services website - Identifying methods for the safe disposal of drugs
• DEA website as a source for locating drug take-back sites.

Any questions about how to dispose of unused or expired medications?

Talk to your local pharmacist or give us a call toll-free at the phone number below.

How does UPMC for Life help members who take many medications?

If you have more than one long-term health condition, take many medications every day, and have an expensive drug therapy regimen, you might feel like you could use some extra help managing your medications.

UPMC Health Plan’s Medication Therapy Management (MTM) program is available at no cost to you. The program is administered by a team of health care professionals that includes pharmacists, registered nurses, and social workers.

If you meet the criteria below, you are automatically enrolled in the program. You don’t have to do anything. If you do not want to participate in this program, please call 1-844-870-2224 (TTY: 711) Monday through Friday from 9 a.m. to 5 p.m. But the program is very helpful. It includes:

• Monthly medication reviews to look for problems, such as drug interactions, duplications in drug therapy, and gaps in care (care you should have gotten but did not).
• Letters and phone calls to prescribers to inform them of potential drug-related issues.
• You may receive a letter or a brief 5- to 10-minute phone call from a health care professional following up about important medication(s) to ensure you are not experiencing any problems or concerns.
• An annual Comprehensive Medication Review (CMR). This is an approximately 30-minute phone call between you and a pharmacist. The pharmacist will talk to you about your medications and listen to any concerns you have about them. After the CMR, you will receive a recommended to-do list and personal medication list in the mail. These materials are sent out within a week of the CMR review. View a blank copy of the personal medication list.

Who is eligible for UPMC for Life's medication management program?

2023
You must meet all criteria of at least one of the two groups (1 or 2) to be eligible for UPMC for Life's MTM program.

1. • Have three or more of the following chronic diseases: asthma, chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, dyslipidemia, HIV/AIDS, hypertension, osteoporosis, osteoarthritis, rheumatoid arthritis.
   • Must have filled eight or more chronic/maintenance Part D covered drugs within a 90-day period.
   • Be likely to incur annual costs that meet or exceed $4,935 for all covered Part D drugs. (UPMC estimates that members whose drug costs equal or exceed $1,233.75 in a 90-day period will have an annual drug cost of at least $4,935.)
2. Enrolled in our Drug Management Program for at-risk members.

2022
You must meet all criteria of at least one of the two groups (1 or 2) to be eligible for UPMC for Life's MTM program.

1. • Have three or more of the following chronic diseases: Alzheimer’s disease, asthma, chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, dyslipidemia, end-stage renal disease (ESRD), HIV/AIDS, hypertension, osteoporosis, transplant, rheumatoid arthritis, schizophrenia.
   • Must have filled eight or more chronic/maintenance Part D covered drugs within a 90-day period.
   • Be likely to incur annual costs that meet or exceed $4,696 for all covered Part D drugs. (UPMC estimates that members whose drug costs equal or exceed $1,174 in a 90-day period will have an annual drug cost of at least $4,696.)
2. Enrolled in our Drug Management Program for at-risk members.