MIPS #PIMSH 16 Appropriate Antiemetic Therapy for High- and Moderate-Emetic-Risk Antineoplastic Agents in the Infusion Center

2025: no changes from 2024 specifications.

Measure Description

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

Relevance to Value Based Care

Chemotherapy-induced nausea and vomiting may discourage patients from completing a chemotherapy regimen, adversely impacts quality of life and a patient’s ability to carry out daily activities, and may require emergency care or hospitalization, adding to the economic burden of healthcare (Aapro et al., 2012).

 Numerator

Numerator Criteria 1: Patients who are administered prior to treatment a four-drug combination of a neurokinin 1 (NK1) receptor antagonist, a serotonin (5-HT3) receptor antagonist, dexamethasone, and olanzapine

Numerator Criteria 2: Patients who are administered prior to treatment a two-drug combination of a 5-HT3 receptor antagonist, and 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 Criteria 1: All patients aged greater than or equal to 18 years diagnosed with cancer who receive their first ever high-emetic-risk antineoplastic agents during cycle 1 of any chemotherapy regimen

 Denominator Criteria 2: All patients aged greater than or equal to 18 years diagnosed with cancer who receive their first ever moderate-emetic-risk antineoplastic agents during cycle 1 of any 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, p. 2787).

Exclusion/Exceptions:

Denominator Exception Criteria 1: Patient allergy or intolerance to neurokinin 1 (NK1) receptor antagonist, serotonin (5-HT3) receptor antagonist, dexamethasone, or olanzapine

 Denominator Exception Criteria 2: Patient allergy or intolerance to 5-HT3 receptor antagonist, or dexamethasone

Telehealth Included: No

Scoring 1-10 points

 RESOURCES