Over 240 patient advocates and health care associations pushed Congress on immediate action to reform pharmacy direct and indirect remuneration (DIR) clawback and performance measure fees, according to a letter sent to Congressional leaders. The letter, which was commended in a joint news release from a number of pharmacy organizations, urged DIR fee reform in order to make prescription drugs more affordable for patients and prevent pharmacies from closing, which would limit access to vulnerable populations.1,2
“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).1
DIR reform has gained bipartisan support from Congress; the letter asserted that DIR clawback and performance measure fees “threaten a pharmacy’s ability to support patients.”1
The joint news release cited data from the Centers for Medicare and Medicaid Services, which found that DIR fees charged by payers to pharmacies have grown by 45,000% since 2010.2
According to the release, among the consequences of DIR fees include inflating Medicare patients’ out-of-pocket expenses for their prescription drugs, as well as threatening the financial stability of pharmacies. Approximately 2000 pharmacies have closed since 2018.2
“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, healthcare organizations, and healthcare 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 wellbeing and can protect against otherwise avoidable emergency department visits, especially at this time,” the groups wrote.1
1. DIR Reform Beneficiary Letter. NACDS; May 7, 2020. Accessed May 7, 2020. https://www.nacds.org/pdfs/government/2020/DIR-Reform-Beneficiary-Letter-0520.pdf.
2. More than 240 Patient, Healthcare Groups Urge Congress to Reform Pharmacy “DIR” Fees This Year. News Release. NACDS; May 8, 2020. Accessed May 8, 2020. https://www.nacds.org/news/more-than-240-patient-healthcare-groups-urge-congress-to-reform-pharmacy-dir-fees-this-year/.