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September 2018

Statin therapy important for patients with cardiovascular disease and diabetes

The Centers for Disease Control and Prevention estimates that adults with diabetes are 1.7 times more likely to die from cardiovascular disease than adults without diabetes. Additionally, almost two out of five people with diabetes who could benefit from statin therapy to lower their risk of future heart attack, stroke and related death weren’t prescribed one, according to the Journal of the American College of Cardiology.

The Centers for Medicare & Medicaid Services focuses three of its star measures on the use of statin therapy, highlighting its importance.

Review the measures described below and consider prescribing statins for your patients diagnosed with atherosclerotic cardiovascular disease and diabetes.

Measure

Definition

Statin Therapy for Patients with Cardiovascular Disease (Part C)

This measure assesses the percentage of males ages 21 to 75 and females ages 40 to 75 who were identified as having clinical atherosclerotic cardiovascular disease and met the following criteria:

  • Received statin therapy: Patients were dispensed at least one high or moderate-intensity statin medication in the measurement year.
  • Statin adherence 80 percent: Patients remained on a high or moderate-intensity medication for at least 80 percent of the treatment period.

When patients aren’t able to tolerate statin medications, patients are excluded from the Statin for Patients with Cardiovascular Disease measure. Ensure your office visit claim includes one of the following ICD-10 codes:

  • G72.0 Drug induced myopathy
  • G72.9 Myopathy unspecified
  • M62.82 Rhabdomyolysis
  • M79.1 Myalgia with nomenclature

The American College of Cardiology and the American Heart Association recommend statins of moderate or high intensity for adults with established clinical atherosclerotic cardiovascular disease. And research supports the use of statins to reduce atherosclerotic cardiovascular disease events in primary or secondary prevention.

Statin Therapy for Patients with Diabetes (Part D)

This measure assesses the percentage of members ages 40 to 75 with diabetes who don’t have clinical atherosclerotic cardiovascular disease and met the following criteria:

  • Received statin therapy: Patients were dispensed at least one statin medication of any intensity during the measurement year.
  • Statin adherence 80 percent: Patients remained on a statin medication of any intensity for at least 80 percent of the treatment period.

Medication Adherence for Cholesterol (statins)

This measure assesses the percentage of people age 18 and older who were dispensed at least two fills of a statin medication and filled the medication for at least 80 percent of the treatment period.

To learn more about statin therapy and why it’s important for people with cardiovascular disease, read our July 2018 article.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.
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