PP_1170x120_10-25-21

PQA endorses pharmacy performance measures

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ALEXANDRIA, Va. The Pharmacy Quality Alliance (PQA), through a majority vote of its members, has endorsed two new pharmacy performance measures. One measure evaluates adherence to three types of medications for health conditions that are major drivers of serious illness, disability, death and health care costs in the United States. The other evaluates the turnaround time of specialty pharmacy prescriptions to help patients receive medication when they need it. 

 The first measure, Proportion of Days Covered Composite (Pharmacy) (PDC-CMP-PH), evaluates the composite percentage of individuals 18 years of age and older, attributed to the pharmacy who met the Proportion of Days Covered (PDC) threshold of 80% for diabetes medications, renin angiotensin system antagonists, which treat hypertension, and statins, which treat high cholesterol.  

 PQA developed this composite adherence measure in response to industry demands for a reliable measure to assess pharmacy quality that is aligned with Medicare Part D measurement and appropriate for use in value-based plan-pharmacy agreements. The measure addresses concerns that health plan quality measures used in Medicare Part D have sometimes been used to assess pharmacy performance often with insufficient denominator size. As it evaluates three types of medications, this composite measure supports reliable performance measurement for pharmacies, especially small, independent and rural pharmacies, which have smaller numbers of patients. 

 The second measure, Specialty Pharmacy Turnaround Time (SP-TAT-PH), evaluates the average number of days between a specialty pharmacy receiving a new prescription for a specialty medication and the prescription being ready for pick-up or scheduled for delivery. Specialty pharmacy focuses on care for patients with complex and chronic conditions and has grown rapidly in recent decades.  

 Studies have demonstrated the importance of early initiation of treatment for many complex conditions, including cancer, multiple sclerosis and rheumatoid arthritis. This measure provides a standardized way of assessing specialty pharmacy prescription turnaround time, a need expressed by many stakeholders.  

 “We are very pleased to add these two new measures to PQA’s set of standardized pharmacy performance measures,” PQA Senior Director of Quality Innovation Lynn Pezzullo said. “We are developing additional pharmacy measures, which are aligned with pharmacy services that improve patient health outcomes and would be suitable for use in pharmacy-payer value-based arrangements.” 

 PQA uses a systematic, transparent and consensus-based process to develop and maintain measures. PQA collaborated with several of its member organizations to test the two measures, a key step in the development process. Working with multiple testing partners allows PQA to evaluate how measures perform across different pharmacies, understand variation in performance and room for improvement and assess the measure’s scientific acceptability.  

“PQA is the consensus and evidence-based organization that is bringing the health care industry together to develop standard pharmacy performance measures focused on improving patient care,” PQA Chief Executive Officer Micah Cost said. “These measures will support transparent and appropriate evaluation of pharmacies. We look forward to supporting the industry’s adoption of these measures and their implementation in value-based programs.” 

 PQA’s staff and Quality Metrics Expert Panel recommended the measures be considered by PQA members for endorsement. A public comment period was held prior to the vote. 

 


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