In a 2021 Drug Store News survey of almost 400 people, 62% of respondents said direct and indirect remuneration, or DIR, fees and reimbursements are the two most important challenges facing retail pharmacy. Things could be changing.
A proposed rule from the Centers for Medicare & Medicaid Services takes some important steps toward reforming the system. However, the rule may only partially remedy the financial impact that these fees — charged to pharmacies after dispensing prescriptions covered by Medicare Part D plans — have on pharmacies and their patients. Prodded by the retail and specialty pharmacy industries, as well as consumer advocacy groups, Congress and CMS have been seeking to tackle the issues surrounding direct and indirect remuneration fees for the past several years. The new proposed rule, which could be finalized by the time you’re reading this, takes aim in particular at the transparency of drug prices, including their associated rebates, among pharmacy benefit managers, pharmacies and their patients.
“It’s been a long time coming,” said Christie Boutte, senior vice president of state strategic affairs and advocacy at the National Association of Chain Drug Stores, or NACDS. “There have been many attempts at addressing DIR fees and their impact on pharmacies, but this is definitely a long-awaited positive move.”
The lack of transparency about the actual cost of a prescription after reimbursements has in many cases resulted in both pharmacies and seniors covered by Medicare paying more for drugs than they should, she said.
“We feel like it should be finalized,” Boutte said. “It is a very key step in moving forward in achieving the reform that we’re looking for.”
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