HEDIS® Tip Sheet

Proportion of Days Covered (PDC)

Endorsed by the Pharmacy Quality Alliance (PQA)

Measure Description

The percentage of members age 18 and older who adhere to their diabetes, hypertension, or cholesterol medications for at least 80% of the prescribed treatment period.

The three measures are:

  • Diabetes All Class
  • Statins
  • Renin Angiotensin System Antagonists

Measure Population:

  • Denominator: Members ages 18 and older as of the first day of the measurement year who were dispensed at least two prescriptions (identified in the table below) on different dates of service during the measurement year. The prescriptions can be the same or different medications.

Medications Included

Diabetes All Class:

  • Biguanides
  • Sulfonylureas
  • Thiazolidinediones
  • Dipeptidyl peptidase (DPP)-IV inhibitors
  • Meglitinides
  • Sodium glucose cotransporter 2 (SGLT2) inhibitor
  • GIP/GLP-1 Receptor Agonists
Renin-angiotensin system (RAS) antagonists:

  • Angiotensin converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Direct renin inhibitor

All Statins








Measure Compliance:

Patients with a medication possession ratio (MPR) or proportion of days covered (PDC) of 80% or higher, indicating adherence to their prescribed therapy.

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Best Practices

  • Include short, easy-to-understand directions with every prescription.
  • Explain why taking the medication is important and the risks of not taking the medication.
  • Educate patients on the dangers of starting and stopping medications abruptly.
  • At each visit, ask patients about their medication use, side effects, missed doses, cost issues preventing adherence, barriers to refilling prescriptions.
  • Recommend pill boxes, reminder apps, or keeping medications visible to help patients remember to take their medications.
  • Simplify the medication regimen whenever possible. Complex dosing schedules can reduce adherence, so consider prescribing options that are easier for patients to follow, such as once-daily dosing, combination medications, or medications that can be taken with food.
  • Once stable, prescribe a 90-day supply and encourage the use of mail-order pharmacy.
  • Advise patients to call if they have side effects.
  • Schedule a follow-up within 30 days of starting a new prescription to check for issues and effectiveness.
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Exclusions

  • Members with end stage renal disease diagnosis
  • Members who use hospice services
  • Diabetes measure only: members with a prescription for insulin.
  • Hypertension measure only: prescription for sacubitril/valsartan

Coding and Benefits Disclaimer

Providers and organizations must submit accurate and complete data in accordance with all billing, coding, and medical policy requirements. HEDIS guidance does not override official coding standards or guarantee reimbursement, as coverage is subject to applicable medical/coding policy and member-specific benefits.

Questions

Should you have specific coding or other questions related to the measure, please send your questions to BlueAlliance@bcbsnd.com.

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Updated 8/28/2026