PQA Concurrent Use of Opioids and Benzodiazepines Performance Measure Endorsed by NQF

This is the Fourth NQF-Endorsed Measure in the PQA Opioid Core Measure Set

Alexandria, Va. (February 13, 2019) – The Pharmacy Quality Alliance (PQA) performance measure for Concurrent Use of Opioids and Benzodiazepines has been endorsed by the National Quality Forum (NQF). The endorsement is part of NQF’s Spring 2018 Cycle of measures for Behavioral Health and Substance Use and included in the standing committee’s final report, which was issued January 11. This is the fourth measure in PQA’s Opioid Core Measure Set endorsed by NQF.

This PQA measure (NQF-endorsed measure #3389) focuses on concurrent use of opioids and benzodiazepines, which aligns with the CDC Guideline for Prescribing Opioids for Chronic Pain. The measure evaluates the percentage of individuals 18 years and older with concurrent use of prescription opioids and benzodiazepines for 30 or more cumulative days. Like the other PQA opioid-prescribing measures, patients in hospice care and those with cancer are excluded.

“Overdose deaths involving prescription opioids are a national epidemic,” said Lisa Hines, PharmD, PQA Vice President for Performance Measurement and Operations. “Although other central nervous system depressants used concurrently may increase the risk of opioid overdose, the clearest evidence exists for risk of harm with benzodiazepines.  This measure, newly endorsed by NQF, addresses a significant performance gap and supports safer opioid prescribing.”

There has been broad national- and state-level interest in the Concurrent Use of Opioids and Benzodiazepines measure, which was added to the 2018 Medicaid Adult Core Set. It has been reported in Medicare Part D Patient Safety reports since 2018 and is planned for Part D display page 2021 (using 2019 data) and 2022 (2020 data). CMS will consider this measure for the 2023 Star Ratings (2021 data) pending rulemaking.

In the second quarter of 2019, PQA anticipates endorsement consideration by PQA membership of three additional draft measures that will evaluate the percentage of individuals 18 years and older with initial opioid prescriptions for:

  • Long-acting/extended release opioids
  • 50 or more morphine milligram equivalent (MME) per day
  • More than 7 days’ supply

These additional measures will be important additions to the PQA Opioid Core Measure Set because they address early opioid use that increases the risk for chronic opioid use and opioid use disorder.


Contact: Richard Schmitz, PQA Senior Director of Communications, [email protected] or 703-347-7931