What you can do
Patients are negatively impacted by insurer and pharmacy benefit manager (PBM) practices such as direct and indirect remuneration (DIR) and other fees that mask the real price of medications, increase the price patients pay, and interfere with pharmacists’ ability to provide patient care.
Pharmacy DIR fee reform is needed immediately to bring down beneficiary out-of-pocket costs and avoid further losses to pharmacies, including closures, that reduce patient access to care. The need for reform is NOW if patients are to retain access to convenient and effective pharmacy services.
Tell Congress to pass legislation that would—
- End post point-of-sale price concessions, such as retroactive pharmacy DIR fees, to ensure consistency throughout all of the Part D benefit.
- Establish standardized pharmacy quality measures for CMS to provide incentive payments to pharmacies.
- Require that Part D sponsors include suitable claim-level detail on the electronic remittance advices that accompany payment.
- Encourage Members of Congress to support the December 2019 version of S. 2543, the Prescription Drug Pricing Reduction Act, which includes a DIR fix that ends retroactive DIR fees.