Pharmacy organizations urge Congress to pass DIR reforms

A group of pharmacy and healthcare organizations, among others, are urging Congress to pass legislation that would halt what they say are the abuse of pharmacy price concessions charged by third-party companies.

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The bill they are seeking passage of is the Pharmacy DIR Reform to Reduce Senior Drug Costs Act (S. 1909/H.R. 3554), which was introduced in the Senate by U.S. Sens. Jon Tester (D-MT) and Shelley Moore Capito (R-WV), and in the House by U.S. Reps. Peter Welch (D-VT) and Morgan Griffith (R-VA).

DIR stands for direct and indirect remuneration. The groups say that billions of dollars in pharmacy DIR fees are assessed weeks, and sometimes months, after the point of sale. These rising fees have led to increased costs for patients and have contributed to pharmacies shutting their doors.

“These fees, which lead to higher costs for beneficiaries at the pharmacy counter, impose ever‐increasing challenges on struggling seniors, putting them at risk for reduced medication adherence and poorer health outcomes. These fees also make it harder for pharmacies to continue operating and providing seniors and special needs populations with the medications and services they desperately need. Many pharmacies have closed over the past few years and have cited DIR fees as a primary cause. These pharmacy closures reduce access to vital healthcare services; especially in rural and underserved areas where healthcare options are already limited,” representatives from 249 organizations wrote in a letter to Congressional lawmakers.

Several coalition members gathered at Grubb’s Pharmacy in Washington, D.C., and walked to the Capitol to present the letter to the bill sponsors. Among the groups are the National Community Pharmacists Association, FMI – The Food Industry Association, the American Pharmacists Association, the National Grocers Association, the National Association of Specialty Pharmacy, and the National Association of Chain Drug Stores.

“Pharmacy DIR fee reform is urgently needed. CMS has stated that eliminating retroactive pharmacy DIR fees will save beneficiaries an estimated $7.1-$9.2 billion in reduced cost-sharing. This common-sense, bipartisan legislation would reduce beneficiary cost-sharing on drugs and eliminate the plans/PBMs clawing back fees from pharmacies, providing increased price transparency for patients and pharmacies. Importantly, this legislation would establish a new pharmacy performance system based on standardized, evidence-based measures to reward and improve quality of care provided by pharmacies,” the letter continued.