Representatives pen letter to Azar on DIR reform

Rep. Cathy McMorris Rodgers, R-Wash., who the National Association of Chain Drug Stores says has been a consistently pro-pharmacy advocate, led a letter to Health and Human Services secretary Alex Azar that was signed by five members of the House Energy and Commerce Committee.

The letter commended Azar for his work on strategies to reduce drug prices and urged him to support provisions in the recently released Centers for Medicare and Medicaid Services’ proposed rule — “Modernizing Part D and Medicare Advantage to Lower Prices and Reduce Out-of-Pocket Expenses.”

The proposed rule would reform the use of pharmacy direct and indirect remuneration, or DIR, fees in the Medicare Part D program, which would reduce patient’s out-of-pocket costs and overall healthcare costs.

The letter notes that in the proposed rule, CMS states that the use of pharmacy DIR fees has increased by an astounding 45,000% between 2010 and 2017. The letter explains that this drastic increase has led to higher out-of-pocket costs for patients, which has caused a coverage gap in their Part D benefit. The lawmakers point out that community pharmacies are having a difficult time keeping their businesses afloat because of the uncertainty the retroactive fees cause. The letter also states that CMS estimates DIR reform would save Medicare beneficiaries $7.1 to $9.2 billion in reduced cost sharing over the next 10 years.

Earlier this year, NACDS submitted comments to CMS in support of the agency’s DIR fee reform proposal described in the proposed rule.

Earlier this month, Congressmen from the Kansas delegation sent a letter to Azar urging CMS to “develop a standard set of performance metrics for pharmacies as soon as possible,” which would lead to improved patient outcomes.

Additionally, a bipartisan Senate letter to Azar, led by Sens. Shelley Moore Capito, R-W.Va. and Jon Tester, D-Mont., and signed by 29 senators, stated: “We believe the policy outlined in the proposed rule would provide needed relief from the impact pharmacy DIR fees have had on patients’ out-of-pocket costs and community pharmacies.”