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Legislators to Azar: Eliminate retroactive DIR fees

Legislators are making their voices heard on the issue of retroactive pharmacy direct and indirect renumeration, or DIR fees. Twenty-one Senators and 83 members of the House of Representatives have sent letters to Health and Human Services secretary Alex Azar, urging him to act on a proposal that would effectively eliminate DIR fees, by requiring that all pharmacy price concessions be accounted for at the pharmacy counter, according to the National Community Pharmacists Association.

"Retroactive fees charged to pharmacies weeks or months after a prescription is dispensed artificially inflate costs to patients," said NCPA CEO Douglas Hoey in a press statement. "Any comprehensive plan aimed at reducing patient prescription drug costs simply must address this issue."

Commending the pharmacy community’s efforts and thousands of grassroots messages sent by individual pharmacists that have increased awareness and support for these letters, Hoey said he is also grateful for Sens. Shelley Moore Capito, R-W.Va. and Jon Tester, D-Mont. in the Senate and Reps. Morgan Griffith, R-Va. and Peter Welch, D-Vt. in the House, for spearheading the letters."Patients, taxpayers, and pharmacies would all benefit from the enhanced pricing transparency resulting from addressing retroactive pharmacy DIR fees," Hoey said.

The letter included strong arguments for moving forward with the proposal, including how patients and taxpayers are negatively affected by retroactive DIR fees.

"DIR fees imposed on pharmacies participating in Medicare Part D networks by plan sponsors and their pharmacy benefit managers have exploded in recent years and have had a crippling impact on patients, Medicare, and pharmacies,” the letter said. “The retroactive nature of these fees means beneficiaries face higher cost-sharing for drugs and are accelerated into the coverage gap (or ‘donut hole’) phase of their benefit. What's more, beneficiaries more quickly reach the catastrophic phase of the benefit, for which Medicare incurs more of the cost of the drugs."
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