Independent Pharmacists: Take Action for Federal DIR Reform

Sign On to Letter Asking Senator Cornyn to Support Federal DIR Reform!

Independent pharmacy owners understand the crushing burden of direct and indirect remuneration (DIR) fees. One of Texas' two U.S. Senators, John Cornyn, sits on the Senate Finance Committee. He is in a position to influence his colleagues to support meaningful federal DIR reform.

The Texas Pharmacy Association, working with the National Community Pharmacists Association (NCPA), is asking independent pharmacists to sign on to a letter to Senator Cornyn asking him to speak with Chairman Grassley and Ranking Member Wyden about the importance of including DIR reform in the committee's drug pricing package as early as next week.

TPA will compile the responses and include their names on the letter.

Text of Letter to Sen. Cornyn:

June 11, 2019

The Honorable John Cornyn
United States Senate
Washington, D.C. 20510

Dear Senator Cornyn:

As pharmacy owners in Texas representing over 1,600 independent pharmacies that employee nearly 15,000 employees, we are writing to urge you to include DIR Reform in the Senate Finance Committee’s drug pricing legislation. Further, we respectfully request you speak with Chairman Grassley and Ranking Member Wyden about the importance of including DIR reform in the drug pricing package.

As you know, the Centers for Medicare and Medicaid Services (CMS) recently missed an opportunity to deliver real cost savings to Medicare beneficiaries when the agency finalized the Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses, CMS-4180-P rule without retaining crucial pharmacy DIR fee reforms that had been proposed. Without pharmacy DIR fee reform, another year could pass before seniors see drug prices lowered at the pharmacy counter.

As CMS itself cited in the proposed rule, DIR fees on pharmacies participating in Part D grew by 45,000 percent between 2010 and 2017. This increase is unacceptable and unsustainable, and it creates uncertainty not only for community pharmacies but also for the patients who rely on Part D prescription drugs. Until pharmacy DIR fee reform occurs, seniors will continue to pay higher cost-sharing for their prescription drugs. CMS estimated that these reforms would have saved Medicare beneficiaries between $7.1 and $9.2 billion in cost sharing over the next ten years.

CMS has studied this issue extensively and heard from thousands of pharmacists and patient advocates during the comment period, as well as 29 members of the United States Senate and 62 members of the House of Representatives encouraging finalization of the pharmacy DIR provisions.

If CMS will not act, then Congress must. For these reasons, we continue to urge the Senate Finance Committee, with your leadership, to deliver seniors real relief from rising prescription drug costs. We stand ready to work with you to determine how we can adopt this much-needed and overdue reform relief this year.