MIPS # PIMSH 15 Antiemetic Therapy for Low- and Minimal-Emetic-Risk Antineoplastic Agents in the Infusion Center - Avoidance of Overuse (inverse)

MEASURE DESCRIPTION

Percentage of cancer patients aged 18 years and older treated with low- or minimal-emetic-risk antineoplastic agents in the infusion center who are administered inappropriate pre-treatment antiemetic therapy.

Relevance to Value Based Care

New antiemetic agents and their combinations are substantially more expensive than older agents, and the use of antiemetic therapy that is not necessary to manage the expected risk of chemotherapy-induced nausea and vomiting contributes to unwarranted healthcare costs (Encinosa & Davidoff, 2017).

 Numerator

Numerator 1: Patients who are administered prior to treatment an NK1 receptor antagonist or olanzapine*

Numerator 2: Patients who are administered prior to treatment an NK1 receptor antagonist, 5-HT3 receptor antagonist, olanzapine, or dexamethasone*

Numerator Guidance: For the purposes of the measure, the following antiemetics would meet the measure*:

  • Antiemetics administered on the same day as cycle 1 day 1 of the therapy OR

  • Any new or refill prescription order of antiemetics on the same day as cycle 1 day 1 of the therapy or within 89 days prior to cycle 1 day 1 of the therapy OR

  • Any record of antiemetics as active on the medication list within 90 days prior to cycle 1 day 1 of the therapy

 Denominator

Denominator 1: Patients who receive low-emetic-risk intravenous antineoplastic agents during cycle 1 of the patient’s first chemotherapy regimen

 Denominator 2: Patients who receive minimal-emetic risk intravenous antineoplastic agents during cycle 1 of the patient’s first chemotherapy regimen

 Denominator Guidance: For multi-drug regimens, select antiemetic therapy based on the drug with the highest emetic risk.  For guidance on determining emetic risk, please refer to Table 1, Emetic Risk of Single Intravenous Antineoplastic Agents in Adults (Hesketh et al., 2020, pp. 2787-1288).

Exclusion/Exceptions

None

Performance Rate Description

Rate 1: The overall performance score submitted is a weighted average of:

(Numerator 1 + Numerator 2)/(Denominator 1 + Denominator 2).

 Scoring

5 points, unless same year benchmark established then 5-10 points.

 RESOURCES

2024 PIMSH15 Measure Specifications.pdf
314.3 KB
LowMinimal_DRCValueSets_UpdateSep2022.xlsx
328.1 KB
PIMSH 15 Drug Guidance.pdf
124.9 KB
PIMSH15 Low to Min risk Antineoplastic Agents Job Aid iKM.pdf
320.6 KB