PQA Endorses Health Plan Migraine Performance Measure and Retires Two Other Measures 

Endorsed Measure Evaluates Migraine Preventive Therapy, Retired Measures Evaluated Drug-Drug Interactions and High-Risk Medication Use in Elderly 

Alexandria, Va. (December 20, 2021) – The Pharmacy Quality Alliance (PQA), through a majority vote of its members, has endorsed one new health plan performance measure and retired two health plan performance measures.  

The newly endorsed measure, Migraine Preventive Therapy (MPT), evaluates the percentage of individuals 18 years of age and older with frequent use of acute migraine treatment medications that also received migraine preventive medications. This clinical guideline-based measure is aligned with American Headache Society and American Academy of Neurology recommendations to provide preventive migraine treatment to patients with chronic migraine. 

“Given that a small percentage of individuals that would benefit from migraine preventive therapy actually receive it, we are pleased to have this measure available as a tool to support patients receiving medication that can reduce their number of headache days and improve quality of life,” PQA Senior Director of Quality Innovation Lynn Pezzullo, RPh, CPHQ, said. 

Measure retirement is part of PQA’s systematic, transparent and consensus-based process to develop and maintain measures. Measures may be retired due to lack of use, lack of opportunity for meaningful improvement, changes in clinical guidelines or the development of newer, more appropriate measures.  

The first measure being retired, Drug-Drug Interactions (DDI), evaluated the percentage of individuals who received a prescription for a target medication during the measurement year and were dispensed a concurrent prescription for a precipitant medication. With low measure rates, which indicates better performance, and little variation, the measure no longer distinguishes good from poor performance. The Centers for Medicare & Medicaid (CMS) retired the DDI measure from the 2022 Medicare Part D Display Page. 

The second measure being retired, Use of High-Risk Medications in the Elderly (HRM), evaluated the percentage of individuals 65 years of age and older who received two or more prescription claims for the same high-risk medication during the measurement year. CMS retired the HRM measure from the Medicare Part D Display Page in 2021.  

With the HRM measure’s retirement, stakeholders can focus resources on newer medication safety measures with greater opportunity for meaningful impact, including PQA’s Polypharmacy: Use of Multiple Anticholinergic Medications in Older Adults (POLY-ACH) and Polypharmacy: Use of Multiple CNS-Active Medications in Older Adults (POLY-CNS), which address the use of multiple medications in older adults. 

PQA’s staff, Measure Update Panel and Quality Metrics Expert Panel recommended that PQA members consider the MPT health plan measure for endorsement and the DDI and HRM health plan measures for retirement. A public comment period was held prior to the vote.