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Statin Use in Persons with Diabetes (SUPD)

A Part D process measure that reports the percentage of members ages 40 to 75 with diabetes who received at least one statin fill during the measurement year. Diabetes is identified from pharmacy claims; exclusions draw on diagnosis codes from medical claims.

Measure steward

PQA

Data source

Part D PDE, medical claims

Weighting category

Process

2027 Star weight

Direction

Higher is better

Period

Calendar year

Specification

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Element	Definition
Denominator	Members ages 40 to 75 with at least two fills of a diabetes medication, including insulin, on different dates of service during the measurement year.
Numerator	At least one fill of a statin or statin combination product, of any intensity, through the Part D benefit.
Exclusions	Hospice; ESRD or dialysis; rhabdomyolysis or myopathy; pregnancy, lactation, or fertility treatment; cirrhosis; prediabetes; polycystic ovary syndrome (PCOS).
Denominator exception (MY2026 onward)	No statin claim and at least one claim for a PCSK9 inhibitor or bempedoic acid.

Diagnosis-based exclusions require a qualifying ICD-10 code on a claim in the measurement year and must be resubmitted each year.

Measure linkage

SUPD and Statin Adherence are sequential. The process measure counts initiation; the adherence measure counts what happens next.

Step 1

SUPD denominator

Age 40 to 75 with two or more diabetes medication fills.

Step 2

SUPD numerator

One statin fill of any intensity closes the gap.

Step 3

Statin Adherence denominator

A second statin fill on a different date enters the member in Statin Adherence.

Step 4

Statin Adherence numerator

PDC ≥ 80% through December 31, in a measure weighted 3 in 2027.

Figure 1. Each SUPD gap closure creates a new Statin Adherence member. Intervention design should cover initiation and persistence together.

Clinical and operational considerations

The measure is a floor, not the guideline. ADA Standards of Care recommend at least moderate-intensity statin therapy for adults 40 to 75 with diabetes regardless of baseline LDL-C. SUPD credits any intensity.
LDL-C at goal is not an exclusion. Prescribers who withhold a statin because LDL-C appears controlled leave the member in the denominator.
Only a statin closes the gap. Ezetimibe monotherapy, fibrates, and samples do not. PCSK9 inhibitors and bempedoic acid remove the member only when no statin claim exists.
Intolerance has to be coded. Statin-associated muscle symptoms exclude the member only with a qualifying myopathy or rhabdomyolysis diagnosis on a claim in the measurement year.
Insulin users count here. Members on insulin are in the SUPD denominator but excluded from the diabetes adherence measure.
Ownership is often unclear. Primary care, endocrinology, and cardiology may each assume another prescriber manages lipid therapy.

Where performance is lost

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Driver	Effect on the measure
LDL-C-based prescribing	Statin withheld when LDL-C appears at goal; member remains open
Undocumented intolerance	Member stays in the denominator without a qualifying diagnosis
Generic gap lists	Prescriber outreach without a specific, patient-level recommendation
Off-benefit fills	Samples and cash fills do not close the gap
No persistence plan	New starts fall out of Statin Adherence after the first fill

Policy watch

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	Change
2027 Star Ratings (MY2025)	Weight 1.
MY2026 onward	PQA denominator exception for members with a PCSK9 inhibitor or bempedoic acid claim and no statin claim.
2029 Star Ratings (MY2027)	Statin Adherence is expected to return to weight 3, raising the value of each SUPD closure that persists.
Measure set	Eleven administrative measures are removed across the 2028 and 2029 Star Ratings. Weights are unchanged, so each remaining measure carries a larger share of the summary and overall ratings.
Litigation	Clover v. HHS (S.D. Ga., May 2026). CMS excluded Part D measures from its recalculated 2027 QBP ratings and has appealed to the 11th Circuit. Part D measures remain in the 2027 Star Ratings measure set.

References

CMS. 2027 Star Ratings Measures and Weights.
Pharmacy Quality Alliance. Statin Use in Persons with Diabetes (SUPD) measure specification.
American Diabetes Association. Standards of Care in Diabetes, cardiovascular disease and risk management.
CMS. Contract Year 2027 Medicare Advantage and Part D Final Rule (CMS-4208-F3), April 2, 2026.
Clover Insurance Co. v. HHS (S.D. Ga., May 27, 2026); CMS memorandum on 2027 Quality Bonus Payment recalculation, June 17, 2026.

Specifications are summarized for education. Consult the PQA measure specifications and CMS Star Ratings Technical Notes for the measurement year in question. Prepared by the MedWatchers clinical pharmacy team, October 2026.