Medication value sets do not include the latest and most effective drug formulations in a drug class

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    • Type: EC eCQMs - Eligible Clinicians
    • Resolution: Done
    • Priority: Moderate
    • Component/s: ValueSet
    • CMS61v6/NQFna
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      Medications formulations are made available to market and preferred by clinicians much sooner than updated value sets. For example, sacubitril/valsartan formulations were frequently prescribed in 2016, but not included in relevant value sets for that performance year. Several measures (134,135,22,61,64) use value set ACE Inhibitor or ARB or
      Anti-Hypertensive Pharmacologic Therapy, but only 135 uses an ingredient value set, ACE Inhibitor or ARB Ingredient, which contains valsartan and allows for more timely use of new combination drugs.

      We recommend 1) expanded use of ingredient based value sets or 2) allow eligible clinicians to apply more recent value set versions (e.g. published for the next reporting year) to the current reporting year.
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      Medications formulations are made available to market and preferred by clinicians much sooner than updated value sets. For example, sacubitril/valsartan formulations were frequently prescribed in 2016, but not included in relevant value sets for that performance year. Several measures (134,135,22,61,64) use value set ACE Inhibitor or ARB or Anti-Hypertensive Pharmacologic Therapy, but only 135 uses an ingredient value set, ACE Inhibitor or ARB Ingredient, which contains valsartan and allows for more timely use of new combination drugs. We recommend 1) expanded use of ingredient based value sets or 2) allow eligible clinicians to apply more recent value set versions (e.g. published for the next reporting year) to the current reporting year.

          Assignee:
          Mathematica EC eCQM Team (Inactive)
          Reporter:
          Nancy Munoz
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