Proportion of Days Covered (PDC)
Endorsed by the Pharmacy Quality Alliance (PQA)
Line of business: Marketplace
Measure Description
The percentage of members 18 years and older who met the Proportion of Days Covered (PDC) threshold of 80% during the measurement year. A higher rate indicates better performance.
A rate is reported for each of the following:
- 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:
| Renin-angiotensin system (RAS) antagonists:
| 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.
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.
- 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.
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 Disclaimer
The analysis of any medical coding question related to a measure is dependent on the measure’s technical specifications including the factual situations present related to the member, the practice, the professionals, and the medical services provided.
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 7/16/2025
