Legislation Addressing DIR Fees Moves Ahead


Legislation aimed to do away with unfair direct and indirect renumeration (DIR) fees is moving forward.

DIR fees

Legislation aimed to do away with unfair direct and indirect renumeration (DIR) fees is moving forward.

A coalition of national pharmacy groups applauded the latest version of the bipartisan Prescription Drug Pricing Reduction Act (S. 2543), which was released last Friday by the Senate Finance Committee.

“This legislation represents a potentially major reform that would generate savings and create pricing transparency for pharmacy patients,” the coalition said in a statement. “It would put a stop to the predatory practice of imposing fees on pharmacies long after the point of sale and charging patients more up front for their drugs.”

The coalition includes the National Community Pharmacists Association, National Association of Chain Drug Stores, American Society of Consultant Pharmacists, National Association of Specialty Pharmacists, Food Marketing Institute, National Grocers Association, American Pharmacists Association, and the National Alliance of State Pharmacy Associations.

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The updated draft of S. 2543 will require all pharmacy price concessions and DIR fees to be included in the negotiated price at point of sale for Medicare Part D starting January 1, 2022. Notably, it would prohibit plans and pharmacy benefit managers from retroactive recoupment, the coalition said.

In addition, the bill would move up the implementation of standardized pharmacy quality measures to 2022.

A previous version of the bill did not address DIR clawbacks. “The current system is unsustainable for patients and pharmacies, and we are grateful to Chairman [Chuck] Grassley and Ranking Member [Ron] Wyden for listening to our members’ concerns. We look forward to working with the Committee and Senate leaders to pass the legislation.”

Pharmacy groups have been battling DIR fees via legislative and advocacy efforts for years. This fall, the coalition lauded a letter from the chairman and a majority of the Senate Finance Committee urging the Trump administration to reform DIR fees.

In the letter, the Department of Health and Human Services is urged to “revive the pharmacy DIR reforms included in [CMS’] November 30, 2018 proposed rule, ‘Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses,’ (CMS-4180-P), and finalize them for plan year 2021.”


Pharmacy Coalition Applauds Needed Pharmacy Patient Reforms in Bipartisan Drug Pricing Package [statement]. NACDS’ website. https://www.nacds.org/news/pharmacy-coalition-applauds-needed-pharmacy-patient-reforms-in-bipartisan-drug-pricing-package/. Accessed Ddecember 10, 2019.

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