By: | Feb-22-19

Rite Aid’s Dan Miller, senior vice president of pharmacy operations, and Rep. Cathy McMorris Rodgers (R-WA) at a previous NACDS RxIMPACT Day on Capitol Hill.

Rep. Cathy McMorris Rodgers (R-WA), a consistently pro-pharmacy advocate, led a letter to Health and Human Services Secretary Alex Azar urging support for provisions in the recently released proposed rule—Modernizing Part D and Medicare Advantage to Lower Prices and Reduce Out-of-Pocket Expenses—by the Centers for Medicare and Medicaid Services (CMS). The proposed rule would reform the use of pharmacy direct and indirect remuneration (DIR) fees in the Medicare Part D program, which would reduce patient’s out-of-pocket costs and overall healthcare costs.

The letter notes that in the proposed rule, CMS states that the use of pharmacy DIR fees has increased by an astounding 45,000 percent between 2010 and 2017. The letter explains that this drastic increase has led to higher out-of-pocket costs for patients, which has caused a coverage gap in their Part D benefit. The lawmakers point out that community pharmacies are having a difficult time keeping their businesses afloat because of the uncertainty the retroactive fees cause. The letter also states that CMS estimates DIR reform would save Medicare beneficiaries $7.1 to $9.2 billion in reduced cost sharing over the next 10 years.

Earlier this year, NACDS submitted comments to CMS in support of the agency’s DIR fee reform proposal described in the proposed rule.

Five members of the House Energy and Commerce Committee signed the letter, which commended Secretary Azar for his work on strategies to reduce drug prices, while also urging swift action on eliminating retroactive pharmacy DIR fees, which would lead to important costs savings for seniors.

Earlier this month, congressmen from the Kansas delegation sent a letter to Secretary Azar urging CMS to “develop a standard set of performance metrics for pharmacies as soon as possible,” which would lead to improved patient outcomes. Also, a bipartisan Senate letter to Secretary Azar, led by Sens. Shelley Moore Capito (R-WV) and Jon Tester (D-MT), and signed by 29 Senators, stated: “We believe the policy outlined in the proposed rule would provide needed relief from the impact pharmacy DIR fees have had on patients’ out-of-pocket costs and community pharmacies.”

As part of an overarching campaign to eliminate DIR fees, NACDS will continue to encourage members of Congress to raise their voices to urge HHS to act in support of DIR fee reform.