PQA Retires Six Health Plan Performance Measures

Minimizing Measurement Burden Through Responsible Stewardship

Alexandria, Va. (February 6, 2020) – The Pharmacy Quality Alliance (PQA), through a majority vote of its members, has retired six health plan performance measures. Measures can 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.

Four of the six measures retired evaluated adherence of individual diabetes medication classes:

  • Proportion of Days Covered: Biguanides
  • Proportion of Days Covered: Dipeptidyl Peptidase-4 Inhibitors
  • Proportion of Days Covered: Sulfonylureas
  • Proportion of Days Covered: Thiazolidinediones

These measures were retired primarily because PQA’s all-class diabetes adherence measure is more meaningful, because diabetes therapy often involves combination therapy. The all-class measure also is more comprehensive of available diabetes medications and can be used for monitoring individual class rates for quality improvement and monitoring.

The fifth measure, Diabetes Medication Dosing, evaluated the percentage of individuals who were dispensed a dose higher than the daily recommended dose for certain therapeutic categories of oral hypoglycemics. With very low reporting rates and little variation, the measure is no longer able to effectively distinguish good performance from bad performance and provides little room for further improvement.

The sixth measure, Use of Benzodiazepine Sedative Hypnotic Medications in the Elderly, was developed as a balancing measure for the Use of High-Risk Medications in the Elderly in the Elderly (HRM) measure, which targets non-benzodiazepine sedative hypnotics, but not benzodiazepines. The HRM measure is being phased out of the Centers for Medicare and Medicaid Services (CMS) Medicare Part D quality programs, leaving little opportunity for implementation.

PQA’s staff, Measure Update Panel and Quality Metrics Expert Panel recommended these six measures be considered by PQA members for retirement. A public comment period was held prior to the vote. As a responsible measure steward, PQA supports efforts to minimize measurement burden by retiring measures no longer relevant or in use. 


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

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