NACDS leaders talk DIR fees, opioid abuse at Total Store Expo

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NACDS leaders talk DIR fees, opioid abuse at Total Store Expo

By Sandra Levy - 08/25/2019
Direct and indirect remuneration, or DIR, fees and advancing pharmacy’s role as part of opioid abuse prevention are complex and critical issues that the National Association of Drug Store Chains is committed to. So said NACDS president and CEO Steve Anderson, speaking at Sunday’s Business Program at NACDS Total Store Expo.

“DIR is absolutely dire,” Anderson said. “For those not familiar with DIR, let’s put it this way: DIR fees are phantom fees. They result from a loophole in a regulation. They are inflating patients’ drug costs. And they are squeezing pharmacies out of business. We are bringing everything we have to this fight. We have to.”

Anderson pointed out that DIR fee relief fell victim to big differences of opinion among key leaders at the highest level of the Trump administration. “Now we have to charge up the big hill — Capitol Hill,” Anderson said, noting that NACDS is collaborating with several associations, including the National Community Pharmacists Association, the American Pharmacists Association and others.

Anderson also told attendees that NACDS is committed to advancing pharmacists’ role in opioid abuse prevention, and is working for federal and state legislation to advance a seven-day limit on patients’ first opioid prescriptions.

“There is a moment of truth when a patient walks into the pharmacy to fill an opioid prescription,” Anderson said. “The pharmacist makes a professional decision: Did the prescriber write this prescription for a legitimate medical purpose? Or is something else going on? That’s one of the most difficult situations in healthcare delivery today. The public recognizes that pharmacies do a lot in the areas under their control.”

Anderson also unveiled NACDS’ new ad, which emphasizes pharmacy’s commitment to opioid abuse prevention. He introduced a new Policy Partners Portal, which invites suppliers’ engagement in pro-patient, pro-pharmacy advocacy, at

Finally, Anderson addressed the growth of the CBD industry and said Food and Drug Administration guidance for clarity on CBD marketing and labeling is on NACDS’ political agenda.

Lane highlights collaboration
Chris Lane, NACDS chairman and executive vice president of Wakefern Food/Shop Rite, followed Anderson’s remarks, further emphasizing that DIR fee relief is the driving focus for the diverse chain membership of NACDS.

“We are diverse in our experience, and we are united in our goals. DIR fees — these phantom fees — do not discriminate,” Lane said.

Lane said phantom DIR fees are raising patients’ drug costs and putting pharmacies out of business.

“It is of vital importance that we need to do more to tell the story of pharmacists’ role in the solution to the opioid problem. The stakes are so high. This is a critical time. The opioid abuse epidemic touches all of us. I ask suppliers for their engagement and help in fighting the DIR fees and advancing opioid abuse solutions,” Lane said.

Lane urged suppliers to write to Congress and tell their stories of how their work for consumers is being harmed by DIR fees, and how the opioid crisis affects Americans. “We need you as part of the conversation,” he said.

Finally, Lane said, “We have big issues. We have big ideas. So thank you for your role in addressing and advancing them at TSE.”

Former Secretary of State John Kerry also addressed attendees during the Business Program. Kerry discussed the need for governments to keep pace with the fast-changing pace of society.

“Governance is not moving faster. This is a real challenge that is bigger than any one issue,” Kerry said. He also noted that the issue of “bigness” among companies will become a major political issue.

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