PQA creates three measures to help track opioid prescriptions

SPRINGFIELD, Va. — The membership of the Pharmacy Quality Alliance has endorsed three new performance measures that assess the use of opioids from multiple providers or at high dosage in persons without cancer. Abuse and overdose of prescription opioids has grown to become a major public health issue in the United States. Studies have shown that people who receive high doses of opioids or prescriptions from multiple prescribers and use multiple pharmacies are more likely to die of drug overdoses. 

 

The first measure assesses populations that are receiving prescriptions for opioids at a high dose that could be inappropriate or could contribute to an adverse event. The second measure assesses populations that are receiving opioid prescriptions from multiple prescribers and multiple pharmacies, which may indicate uncoordinated care and/or doctor/pharmacy shopping. And the third measure includes criteria of both high dose opioids and also receiving prescriptions from multiple providers - which may indicate misuse, abuse or inappropriate and/or fragmented care.

 

During testing, the PQA measure rates were calculated for five plans, including one commercial, three Medicare Advantage and one stand-alone prescription drug plan. Testing revealed substantial variability across these plans, and patterns that may prove useful in designing interventions. PQA collaborated with RxAnte to test the new opioid utilization measures, utilizing data from Aetna and WellCare. 

 

"Abuse and overdose of prescription opioids is a major public health issue in the US. These measures will become important tools used in addition to other federal and state-based monitoring systems," said Woody Eisenberg, SVP PQA.

 

"Unsafe use of prescription opioids is a growing epidemic that costs the U.S. an estimated $70 billion annually and leads to nearly 100,000 avoidable ER visits each year," added Josh Benner, EVP strategy at Millennium Health. "We are pleased to collaborate with PQA, Aetna and WellCare on these new performance measures which will help to establish the foundation for addressing this important public health issue."