NCPA CEO to Trump: Fix DIR fees to lower drug costs

A letter from National Community Pharmacists Association CEO B. Douglas Hoey to President Trump asserts that along with any efforts on drug pricing, the administration must end back-door fees that insurance companies use to raise drug prices for older adults and gouge area pharmacies. “If policymakers were to change the current policy and end the secretive rebate game without also reforming pharmacy DIR, there is no doubt in my mind that PBMs will maneuver to leverage even more DIR fees to make up the difference,” Hoey wrote. “To be effective, administration efforts on drug pricing must include pharmacy DIR fee reform, a vital component in truly lowering drug costs and maintaining access to community pharmacy services.” According to CMS, DIR fees increased 45,000% between 2010 and 2017, Hoey said. Additionally, an XIL Consulting analysis revealed “DIR pharmacy fees overall have skyrocketed by 1,600% in the last 5 years, totaling $8.5B since 2013.” Also noting a recent JAMA Network Open study which found that older Americans go to community pharmacies almost twice as often as their primary care doctors, Hoey said: “Community pharmacies are the most accessible health care providers in the country, and DIR fees are shutting them down. The administration must fix this problem before it is too late.”