Lawmakers seek to eliminate DIR fees as part of COVID-19 relief efforts

Lawmakers are seeking to eliminate DIR fees as the coronavirus pandemic continues straining small business, independent community pharmacies.

One hundred fifteen members of the U.S. House of Representatives are supporting a bipartisan push to include language permanently prohibiting pharmacy DIR clawbacks by pharmacy benefit managers in future coronavirus relief packages. 

A letter, led by Reps. Buddy Carter, R-Ga., Peter Welch, D-Vt., Doug Collins, R-Ga., Raja Krishnamoorthi, D-Ill. and Vicente Gonzalez, D-Texas, was sent to House Speaker Nancy Pelosi, Majority Leader Mitch McConnell, Senate Minority Leader Charles Schumer and House Minority Leader Kevin McCarthy.

The letter stated, "We must keep pharmacies open during this crisis. Pharmacy DIR reform has strong bipartisan support in both the House and Senate. We ask for these reforms to be enacted now and hope that Members of Congress will not overlook the critical need to ensure the sustainability of pharmacies during this public health emergency."

A National Community Pharmacists Association analysis released last week found that 66% of independent pharmacies are experiencing such negative cash flow issues as DIR fees, decreasing reimbursement and coronavirus-related expenses. That means pharmacies are paying more for inventory and clawback fees, which makes it difficult to stay in business, NCPA said.

“Independent pharmacies are stepping up to help their communities through the coronavirus crisis," NCPA CEO Doug Hoey said. "They are expanding home delivery zones, putting their own health and safety on the line, continuing to provide a paycheck to thousands of workers — quite literally, they are doing more with less as PBMs claw back funds and reimburse prescriptions below the pharmacy’s cost."

NCPA noted that half of pharmacy owners reported paying more than $10,000 in pharmacy DIR fees since March 1. If this pace continues, the average independent pharmacy will be on track to have over $100,000 clawed back in the next 12 months.

"The majority of neighborhood pharmacies are already experiencing negative cash flow issues and, for their efforts to help through this pandemic, will get a big bill months from now as PBMs come calling for DIR fees," Hoey said. "Eliminating these fees and reining in PBMs has never been more vital if pharmacies are to continue operating now and when this emergency passes. Our continued thanks to those policymakers who understand this and are fighting for PBM reform.”