Direct and indirect remuneration (DIR) fees continue to rise at an alarming rate, inflating seniors’ out-of-pocket prescription drug costs and jeopardizing the viability of pharmacies and patient access.
Previously, the Centers for Medicare & Medicaid (CMS) Services found that pharmacy DIR fees exploded by 45,000 percent between 2010-2017.
Now, as the President’s Fiscal Year (FY) 2022 budget has been finalized, federal agencies are presenting their budget requests to Congress. An updated evaluation in the CMS 2022 Congressional Justification Estimates for Appropriations shows that DIR fees have skyrocketed by 91,500 percent:
“Pharmacy price concessions account for a larger share than ever before of reported DIR and thus a larger share of total gross drug costs in the Part D program. The data show that pharmacy price concessions, net of all pharmacy incentive payments, grew more than 91,500 percent between 2010 and 2019.”
As DIR accelerates, so too does the burden on seniors who rely on prescription medications in the form of higher co-pays and out-of-pocket costs. NACDS continues to work with other pharmacy organizations to confront DIR fees and to position DIR and pharmacy quality measure issues as priorities for the ultimate benefit of the Medicare patients who depend on the quality care provided by pharmacies and pharmacists.
On May 27, NACDS and seven other pharmacy stakeholders praised the introduction of drug-pricing legislation (S. 1909/ H.R. 3554) which seeks to relieve patients and pharmacies from pharmacy DIR fees. The coalition is urging its passage and enactment this year.
