PQA Performance Measure for Initial Opioid Prescribing for Long Duration Endorsed by NQF

Alexandria, Va. (March 31, 2021) – The Pharmacy Quality Alliance (PQA) performance measure “Initial Opioid Prescribing for Long Duration” has been endorsed by the National Quality Forum (NQF). The endorsement is part of NQF’s Spring 2020 cycle of measures for Patient Safety and is included in the standing committee’s final report, which was published March 15. This is the sixth of eight PQA opioid measures endorsed by NQF. 

This PQA measure (NQF-endorsed measure #3558) evaluates the percentage of individuals 18 years of age and older with one or more initial opioid prescriptions for more than 7 cumulative days’ supply, in alignment with the CDC Guideline for Prescribing Opioids for Chronic Pain. Like many PQA opioid-prescribing measures, patients in hospice care and those with cancer or sickle cell disease are excluded. Substantial evidence has demonstrated the link between initial opioid prescribing at long duration and increased likelihood of high-risk and long-term opioid use, misuse, overdose and other negative outcomes.

“As the United States continues to grapple with the opioid epidemic, prescription opioids for pain management remain a major contributor to the crisis,” said Lisa Hines, PharmD, CPHQ, PQA Vice President of Performance Measurement. “This measure, newly endorsed by NQF, addresses a recognized gap in opioid quality measurement and represents an impactful upstream opportunity for intervention that can reduce unintended long-term opioid use and misuse before it occurs.”

There has been significant national and state-level interest in the Initial Opioid Prescribing for Long Duration measure. The Centers for Medicare & Medicaid Services (CMS) will begin reporting the measure in Medicare Part D Patient Safety reports for the 2020 measurement year and plans to add the measure to the Part D display page for 2021 and 2022 measurement years. Additionally, the measure has been adapted for use in the Part D Enhanced Medication Therapy Management program.

CMS also has implemented a new PQA-stewarded opioid-related measure, Annual Monitoring for Persons on Long-Term Opioid Therapy, into the Health Insurance Exchanges Quality Rating System, which provides quality reporting for Qualified Health Plans on the individual market. The measure improves patient safety by evaluating whether patients on long-term opioid therapy receive guideline-recommended annual drug screening, which allows providers to evaluate risks for drug-drug interactions, identify warning signs for development of opioid use disorder, and avoid other negative outcomes.


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