How Has the ‘DIR Hangover’ Impacted Independent Pharmacies in 2024?


Drug Topics sat down with Douglas Hoey, CEO of NCPA, at the 2024 AAP annual conference to discuss how independent pharmacies are doing so far this year.

The National Community Pharmacists Association (NCPA) conducted a poll recently to assess the impact of the DIR hangover on independent pharmacies. The results showed that 32% of respondents said that they are considering shutting down in 2024 because of the cash crunch and 93% said they might drop out of Medicare Part D next year if what they are experiencing now continues.

At the American Associated Pharmacies (AAP) Annual Conference, held April 4 to 6 in San Diego, California, Drug Topics sat down with Douglas Hoey, CEO of NCPA, to discuss the results of the poll and what both congress and CMS can do to help mitigate the impact of the DIR hangover on independent pharmacies.

“For the average independent, 36% of their business comes from Medicare," Hoey said. "It’s a huge decision if they choose not to participate in Medicare. The other thing is that, even if a fraction of that 93% made the individual decision not to participate in Medicare in 2025, it would be devastating to the program and millions of patients would either have to find another pharmacy or they would perhaps even have to do without health care.”

Hoey noted that there are plenty of things that congress and CMS can do to help, but they have so far chosen not to do so. One of those things is passing some form of PBM reform legislation that is pro consumer and pro pharmacy, such as a cost plus reimbursement formula that could save the county around $1 billion dollars.

“There are lots of ways for congress and CMS to take action,” Hoey said. “And we are a little frustrated that congress and CMS have sat on their hands instead of doing something, especially this year where it’s very dire as far as patients not getting access to pharmacies.”

Click here to follow along with all of our AAP 2024 coverage.

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