News Releases

Legislators Urge Sec. Azar to Eliminate Retroactive Pharmacy DIR Fees

by NCPA | Aug 03, 2018

ALEXANDRIA, Va. (August 3, 2018) — In separate letters to Health and Human Services Secretary Alex Azar, 21 Senators and 83 members of the House of Representatives urged him to move forward with a proposal that would effectively eliminate retroactive pharmacy DIR fees by requiring that all pharmacy price concessions be accounted for at the pharmacy counter.

"Retroactive fees charged to pharmacies weeks or months after a prescription is dispensed artificially inflate costs to patients," said National Community Pharmacists Association CEO B. Douglas Hoey, Pharmacist, MBA. "Any comprehensive plan aimed at reducing patient prescription drug costs simply must address this issue."

"I'm heartened by the unified and coordinated efforts of the pharmacy community and the thousands of grassroots messages sent by individual pharmacists that have raised awareness and garnered support for these letters," Hoey added. "I'm also very grateful for the strong leadership of Sens. Shelley Moore Capito (R-W.Va.) and Jon Tester (D-Mont.) in the Senate and Reps. Morgan Griffith (R-Va.) and Peter Welch (D-Vt.) in the House, who spearheaded these letters. Patients, taxpayers, and pharmacies would all benefit from the enhanced pricing transparency resulting from addressing retroactive pharmacy DIR fees."

The letter included strong arguments for moving forward with the proposal, including how patients and taxpayers are negatively affected by retroactive DIR fees:

    "DIR fees imposed on pharmacies participating in Medicare Part D networks by plan sponsors and their pharmacy benefit managers (PBMs) have exploded in recent years and have had a crippling impact on patients, Medicare, and pharmacies. The retroactive nature of these fees means beneficiaries face higher cost-sharing for drugs and are accelerated into the coverage gap (or "donut hole") phase of their benefit. What's more, beneficiaries more quickly reach the catastrophic phase of the benefit, for which Medicare incurs more of the cost of the drugs."

In addition, 153 pharmacy stakeholder organizations sent a similar letter to Azar last month urging him to address pharmacy DIR fees.


The National Community Pharmacists Association, founded in 1898, represents the nation's community pharmacists, including the owners of more than 24,000 pharmacies. The nation's independent pharmacies, independent pharmacy franchises, and independent chains dispense nearly half of the nation's retail prescription medicines.