DIR Fee Relief

“We may be just days from learning whether a pending Medicare rule will provide relief from pharmacy direct and indirect remuneration (DIR) fees, and thus live up to the vision of ‘American Patients First: The Trump Administration Blueprint to Lower Drug Prices and Reduce Out-of-Pocket Costs,’” writes NACDS President & CEO Steven C. Anderson, IOM, CAE, in a post on Medium today.


  • The opinion piece describes a four-part sequence by which DIR fee relief will save money for patients and for the government alike.
  • NACDS cites research that makes a compelling case for DIR fee relief – including that related to medication adherence, or patients’ taking medications as prescribed.
  • Graphical representations of the case for DIR fee reform accompany the Medium post.

“DIR fee relief, proposed by Health and Human Services Secretary Alex Azar, remains essential to save money for patients and for the government alike. This opportunity can be described in a four-part sequence: DIR relief will reduce patients’ cost-sharing for medications, which increases the medication adherence – or patients’ taking their medications as prescribed, which improves overall health, which ultimately reduces government costs.”

– NACDS President and CEO Steven C. Anderson, IOM, CAE

See Opinion Piece
See One-Page Fact Sheet