Characterizing Medicare Medication Therapy Management program enrollees with central nervous system-active
Anna Hung1,2,3, Lauren E Wilson1, Valerie A Smith1,4,5
1Department of Population Health Sciences, Duke University School of Medicine, Durham, NC.
Journal of Managed Care & Specialty Pharmacy
|December 24, 2025
Summary
Over 10% of Medicare Part D Medication Therapy Management (MTM) enrollees have central nervous system (CNS)-active polypharmacy. These individuals, often male and dually enrolled, require tailored interventions due to higher comorbidity and healthcare use.
Area of Science:
- Geriatric Pharmacy
- Health Services Research
- Public Health
Background:
- Medicare Part D Medication Therapy Management (MTM) aims to reduce medication-related problems in older adults.
- Central nervous system (CNS)-active polypharmacy is a significant concern, linked to cognitive impairment and falls in the elderly.
- Limited data exists on CNS-active polypharmacy prevalence and characteristics within MTM enrollees.
Purpose of the Study:
- To determine the prevalence of CNS-active polypharmacy among Medicare MTM enrollees nationwide.
- To compare patient demographics, health status, and MTM service utilization between MTM enrollees with and without CNS-active polypharmacy.
Main Methods:
- A cross-sectional, observational study utilized Medicare 5% fee-for-service data from 2019-2021, linked with 2020-2021 MTM data.
- Patient characteristics and MTM service use were analyzed and compared between enrollees with and without CNS-active polypharmacy.
Main Results:
- In 2021, 10.7% of 38,733 MTM enrollees experienced CNS-active polypharmacy.
- The CNS-active polypharmacy group was more likely male, dually enrolled in Medicaid, and had higher comorbidity burden and prior healthcare utilization.
- This group also had higher prescription drug use but lower participation in Comprehensive Medication Reviews (CMRs) compared to those without CNS-active polypharmacy.
Conclusions:
- CNS-active polypharmacy affects over 1 in 10 MTM enrollees, exceeding general Medicare beneficiary rates.
- These enrollees present complex clinical and socioeconomic needs, necessitating specialized MTM interventions.
- Increased CMR participation is crucial for mitigating risks associated with CNS-active polypharmacy in this vulnerable population.
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