NCPA addresses No. 1 issue facing independents in Morning Consult op-ed

WASHINGTON - The issue of direct and indirect remuneration fees (DIR) has become a hot-button issue for retail pharmacy, Doug Hoey, CEO of the National Community Pharmacists Association, expressed in an op-ed published by Morning Consult Wednesday.



"These fees often result in enormous clawbacks taken from community pharmacies weeks or months after prescriptions are filled," Hoey wrote. "Approximately 67% of respondents said that PBMs provide no information as to how much and when DIR fees will be collected or assessed, and 87% of pharmacists said 'DIR fees' significantly affect their pharmacy’s ability to provide patient care and remain in business."



Hoey concluded: "To allow PBMs to game the system with these retroactive DIR fees is unfair, it clearly hurts the viability of community pharmacies and inevitably endangers Medicare beneficiaries’ access to prescription drugs."



DIR fees has become the No. 1 issue facing independent pharmacists. Earlier this week, NCPA joined a wide array of 99 pharmacy stakeholders in a letter to the sponsors and original co-sponsors of S. 3308/H.R. 5951, the Improving Transparency and Accuracy in Medicare Part D Spending Act, praising their leadership for introducing these companion bills and strongly endorsing the legislative measure which would rein in these fees.



The letter highlighted that the proposed legislation strikes a balance between increasing transparency and not increasing costs: "Furthermore, it successfully achieves greater transparency without raising costs in Medicare Part D while not interfering with the ability of PBMs to create incentive-based payment models that reward pharmacies for achieving contractual-based metrics."



The signatories also cautioned that DIR fees not accounted for at point of sale have an adverse effect on Medicare beneficiaries, "...DIR fees that are not accounted for upfront inflate drug costs at the pharmacy counter, and therefore beneficiary cost sharing."