; and (BB) may not apply any other incentive payments and adjustments with respect to such payment outside of such system. Application of such system may not result in a decrease in reimbursement to such pharmacy for such drug after the point-of-sale of such drug. (bb) Standard pharmacy quality measures The Secretary shall establish standard quality measures that may be used in a system described in item (aa). Such measures shall be— (AA) focused on improving patient health outcomes; (BB) standardized across PDP sponsors; (CC) pharmacy-specific in application; (DD) relevant to the type of pharmacy concerned (such as specialty pharmacies), taking into account the items and services furnished by the pharmacy and the patient population served by the pharmacy; (EE) applied only when relevant to the specific drug (or drug class of such drug) being furnished by the pharmacy or when relevant to management of the condition for which such drug has been prescribed