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PQA endorses three new quality performance measures for opioids

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ALEXANDRIA, Va. – The Pharmacy Quality Alliance (PQA), through a majority vote of its members, has endorsed three new performance measures that evaluate initial opioid prescriptions: at high dosage, for long duration, or for long-acting or extended-release opioids. The measures are aligned with the CDC Guideline for Prescribing Opioids for Chronic Pain and retrospectively evaluate health plan performance for these prescriptions, which are associated with an increased risk for chronic opioid use and opioid use disorder.

Laura Cranston

“High-dose, long-term and long-acting initial opioid prescriptions are linked to greater risks of misuse and overdose,” said Laura Cranston, PQA chief executive officer. “These new quality performance measures will help health plans evaluate these prescriptions. Despite the known risks, starting opioids at high dosages remains prevalent in the United States. As part of our national effort to combat the opioid crisis, these measures support safe use of prescription opioids.”

The three measures include:

  • Initial Opioid Prescribing at High Dosage: The percentage of individuals 18 years of age or older with one or more initial opioid prescriptions with an average daily morphine milligram equivalent (MME) of 50 or more;
  • Initial Opioid Prescribing for Long Duration: The percentage of individuals 18 years of age or older with one or more initial opioid prescriptions for more than seven cumulative days’ supply; and
  • Initial Opioid Prescribing for Long-Acting or Extended-Release Opioids: The percentage of individuals 18 years of age or older with one or more initial opioid prescriptions for long-acting or extended-release opioids.

The measures are part of PQA’s Opioid Core Measure Set, which now has seven measures to evaluate patients with prescriptions for opioids. The other measures in the set evaluate:

  • Concurrent Use of Opioids and Benzodiazepines (NQF #3389);
  • Use of Opioids at High Dosage in Persons Without Cancer (NQF #2940);
  • Use of Opioids from Multiple Providers in Persons Without Cancer (NQF #2950); and
  • Use of Opioids at High Dosage and from Multiple Providers in Persons Without Cancer (NQF #2951).

PQA collaborated with multiple health plans and testing partners, including axialHealthcare, Blue Shield of California and the University of Mississippi Center for Pharmaceutical Marketing and Management, to evaluate the new measures.

“We are grateful for their participation in this process, which helps us understand variation in performance across health plans and whether there is room for improvement,” said Lisa Hines, PQA vice president for Performance Measurement and Operations. “Backed by our members’ endorsement, we look forward to broad implementation of these measures as a key element in a multi-faceted approach to address the opioid epidemic.”


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