Provider Insider


| Issue No. 12

Optimizing medication use is an important aspect of value-based care. The 2021 single scorecard includes generic dispensing rate as a “cost” performance metric and in 2022, medication adherence to statins in patients with diabetes will be added as a “clinical” performance metric.

Generic dispensing rate:

Generic medications not only save the health system valuable health care dollars, they are also often much less expensive for patients. It is estimated that only 39% of branded medication copays are under $20. By comparison, 90% of generic medication copays are under $20.1

The Dirty Dozen list identifies 12 common high-cost, brand-name medications that do not generally provide additional therapeutic benefit over their generic alternatives. This list can be a useful tool to identify common brand-name medications you may be prescribing, as well as recommended alternative medications to consider. Changing a medication on this list to a lower-cost generic has the potential to save anywhere from $1,000 to $60,000 annually, depending on the medication.

Statin adherence in patients with diabetes:

Statins are among the most effective medications in reducing the risk of cardiovascular disease. Using statin therapy in patients with diabetes is estimated to prevent one vascular event for every 15-32 patients treated for 3-5 years.2,3 However, a major barrier to statin benefits is nonadherence. Fifty percent or more of patients have been estimated to be nonadherent to statins after one year.4-6

One practical tip to improve statin adherence is prescribing a 90-day supply and/or using a mail order pharmacy. This increases the amount of medication patients have on hand and limits the number of trips patients need to take to the pharmacy.