U.S. Sen. Ron Wyden (D-OR) is urging the Centers for Medicare and Medicaid Services (CMS) to finalize the proposal that applies all pharmacy direct and indirect remuneration (DIR) fees to drug prices at the point of sale.
Pharmacy DIR fees that are applied after the point of sale artificially inflate patients’ out-of-pocket costs for Part D drugs, Wyden said. Applying them at the point of sale will reduce out-of-pocket prescription drug costs by $21.3 billion over 10 years.
“CMS must take the next step in finalizing the proposal to move all pharmacy DIR to the point of sale in a reasonably expedient manner and without any compromises. Doing so will meaningfully ease the financial strain on thousands of independent pharmacies and millions of Medicare beneficiaries across the nation,” Wyden, the chair of the Senate Finance Committee, wrote in a letter to the CMS. “By constraining these out-of-control fees and requiring additional transparency, this action will help communities that count on these pharmacies for access to medicine and quality local service.”
Pharmacy DIR fees grew more than 107,400 percent between 2010 and 2020, Wyden said. The rise of these fees and the lack of transparency in their application to pharmacy reimbursement resulted in both the closure of hundreds of pharmacies and higher prescription drug costs. It is particularly problematic for small and independent pharmacies, often in rural and underserved areas. Wyden also urged CMS to conduct a formal review of pharmacy closures in the United States in the last five years.