National Association of Specialty Pharmacy President and CEO Sheila Arquette, RPh stated, “We are extremely grateful to CMS for beginning the process of addressing pharmacy DIR reform. CMS has a real opportunity to reduce senior drug costs through pharmacy DIR reform, and it also has a critically important opportunity to eliminate the practices that are reducing or eliminating patient access to pharmacies of their choosing and reducing pharmacy market competition. The rule makes important reforms but simply does not go far enough. The statistics about the growth of DIR fees speak for themselves and are unsustainable for pharmacies.”
Pharmacy DIR fees are monies received by pharmacy benefit managers (PBMs) and Part D plans and include concessions pharmacies are forced to pay after, and sometimes up to six months after, they have dispensed medications to seniors. Pharmacy DIR fees result in profit for PBMs/payers while forcing pharmacies to fill Medicare prescriptions below cost.
“CMS has the legal authority to ensure that anti-competitive practices against pharmacies come to an end. Many pharmacies have closed or consolidated as a result of these practices and these reforms are long overdue,” said Arquette.
NASP asked that the proposed rule be finalized this year with immediate additional protections included for pharmacies to go into effect in 2023. Specialty pharmacies throughout the country submitted comments to CMS and over 230 stakeholders joined together to issue comments in a letterthat NASP helped to coordinate.
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