Pharmacy groups tell HHS that any action on rebate rule must involve fixing pharmacy DIR fees

APhA and other leading pharmacy groups said in a letter to HHS Secretary Alex Azar that any action on a prescription drug rebate rule must address escalating fees extracted by PBMs on behalf of plan sponsors in Medicare Part D. “We remind the Administration of the continuous and heightened impact of pharmacy DIR fees imposed by Medicare Part D plan sponsors and their PBMs on our members,” the letter stated. “Pharmacy DIR fees are growing beyond CMS’ projection of 10% year-over-year. This growth of pharmacy DIR fees is especially unsustainable during the current COVID-19 PHE when our members, representing every aspect of the pharmacy industry, care for patients, while also providing desperately needed access to COVID-19 tests and related services.” The group warned that “without pharmacy DIR fee reform, the impact of implementing a system to pass rebates onto patients at the pharmacy counter may prove disastrous for pharmacies.” Representatives of the groups spoke with HHS last week prior to the president’s signing of several executive orders, including one that would address manufacturer rebates also collected by PBMs on behalf of plan sponsors. “The system contemplated by the rebate rule cannot go into effect without, at a minimum, ensuring that retroactive pharmacy DIR fees are eliminated, therefore saving Medicare beneficiaries at least $7.1 to $9.2 billion in reduced cost sharing over 10 years,” the letter concluded.