OBJECTIVES: Alogliptin-pioglitazone (alo-pio) reduces HbA1c levels in treatment-naïve Type 2 diabetic (T2DM) patients, or those inadequately controlled by monotherapy. Yet, the percentage of patients on alo-pio continuing to meet HbA1c thresholds suggested by the National Committee for Quality Assurance (NCQA) is unclear but may be important to accountable care organizations (ACOs). This analysis examined whether NCQA recognition, aligning with >40% of patients below 7%, >60% below 8%, and ≤15% above 9% HbA1c, is achievable. METHODS: Simulations estimated 1- and 3-year HbA1c progression for 1000 hypothetical T2DM patients (average 7 (SE 5.1) years post-diagnosis) to obtain the proportion meeting criteria for <7%, <8% and >9% thresholds by bootstrapping the UK Prospective Diabetes Study (UKPDS) 68 equation. UKPDS68 accounts for time, HbA1c in the prior year, drug treatment effect, and baseline A1c. Parameter values for duration of diabetes, baseline HbA1c, and treatment effect were selected from distributions around the mean, and mean values of the latter two were systematically varied to approximate different populations and effects. RESULTS: By 1 year, all NCQA requirements are met when treating patients with alo-pio if average baseline HbA1c is ≤8%. At 3 years, all requirements are met in patients with baseline HbA1c ≤7.2%, though 8% and 9% threshold requirements are feasible with higher baseline HbA1c. Using a more realistic thiazolidinedione durability assumption (annual rosiglitazone HbA1c increase) instead of UKPDS68, all thresholds are met at 1 year ≤8% baseline HbA1c, and at 3 years with ≤7.4% baseline HbA1c. The 7% and 8% requirements are met with ≤8.2% baseline HbA1c at 1 year; at 3 years, 8% and 9% thresholds can be met with baseline HbA1c ≤8-8.2%. CONCLUSIONS: The simulations show that clinical thresholds can be met at 1 and 3 years, indicating that alo-pio can be considered for treating an appropriate population from an ACO perspective.