Patient groups call on Congress for DIR fee reform

More than 200 other patient advocates and health care entities on Friday urged Congressional leaders to act now on reforming direct and indirect remuneration (DIR) fees to lower patients' prescription drug prices and to help prevent pharmacy closures.

More than 200 other patient advocates and health care entities on Friday urged Congressional leaders to act now on reforming direct and indirect remuneration (DIR) fees to lower patients' prescription drug prices and to help prevent pharmacy closures. "Members of Congress should not overlook the clear and present opportunity to address these needed reforms this year," the groups wrote to Senate Majority Leader Mitch McConnell (R-KY), Senate Minority Leader Charles Schumer (D-NY), Speaker of the House Nancy Pelosi (D–CA), and House Minority Leader Kevin McCarthy (R-CA). DIR fees charged by payers to pharmacies have increased by 45,000% since 2010, according to CMS data, jeopardizing the viability of pharmacies. The United States now has approximately 2,000 fewer pharmacies than 2 years ago. "On behalf of Medicare Part D beneficiaries, we urge you to advance legislative efforts to reform pharmacy DIR clawback and performance measure fees. We write to you on behalf of patients, pharmacies, health care organizations, and health care practitioners who are working collaboratively to ensure access to needed prescriptions, particularly during the COVID-19 pandemic. Patient medication access is vital to patient health and well-being and can protect against otherwise avoidable emergency department visits, especially at this time," the groups wrote. The letter was praised by a pharmacy coalition including APhA, the National Community Pharmacists Association, National Association of Chain Drug Stores, American Society of Consultant Pharmacists, National Association of Specialty Pharmacists, the Food Industry Association, National Grocers Association, and the National Alliance of State Pharmacy Associations.