Sept. 11, 2025
To help you close our members’ care gaps, we track the following National Committee for Quality Assurance quality measures related to statin therapy:
Statin Therapy for Patients with Cardiovascular Disease assesses the percentage of men ages 21 to 75 and women 40 to 75 with clinical atherosclerotic cardiovascular disease who:
- Were dispensed at least one high-intensity or moderate-intensity statin medication during the measurement year, and
- Remained on a high-intensity or moderate-intensity statin medication for at least 80% of the treatment period
Statin Therapy for Patients with Diabetes assesses the percentage of members ages 40 to 75 with diabetes who don’t have ASCVD who:
- Were dispensed at least one statin medication of any intensity during the measurement year, and
- Remained on a statin medication of any intensity for at least 80% of the treatment period
Consider these tips for our members on statin medication
- Discuss the proper dose and frequency, and why it’s important to remain on medication as prescribed. Consider converting their medication to a 90-day supply through mail order or a retail pharmacy to encourage adherence.
- Discuss common side effects of statin use and what to do if our member has problems with the medication. Remind members to contact you if they think they’re experiencing side effects.
- Review members’ medication profiles to confirm statin use history at follow-ups. Clearly document any diagnosis indicating an intolerance to statin therapy and any drug interactions with current medications.
Resources
- Preventive care and clinical practice guidelines
- U.S. Preventive Services Task Force recommendation on statin use for the primary prevention of cardiovascular disease
The above material is for informational purposes only and is not a substitute for the independent medical judgment of a physician or other health care provider. Physicians and other health care providers are encouraged to use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment. References to other third-party sources or organizations are not a representation, warranty or endorsement of such organization. The fact that a service or treatment is described in this material, is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider.