News Releases

Senators to Trump Administration: Fix Pharmacy DIR

by NCPA | Jun 11, 2019

ALEXANDRIA, Va. (June 11, 2019) — After the Trump administration last month released a final drug pricing rule that failed to reform pharmacy direct and indirect remuneration fees, or pharmacy DIR, 28 members of the U.S. Senate have sent a letter to President Donald Trump and leaders in his administration expressing their disappointment and encouraging that pharmacy DIR reform be finalized this year. The letter was led by Sens. Shelley Moore Capito (R-W.Va.) and Jon Tester (D-Mont.). Members of the U.S. House of Representatives are circulating a similar letter.

In their letter, the senators said, “While we commend the administration for your goal to reduce seniors' out of pocket costs for prescription drugs, we believe that finalizing this rule without including DIR reform is a missed opportunity to deliver real cost savings to Medicare beneficiaries. Without DIR reform, another year could pass before seniors see drug prices lowered at the pharmacy counter.”

The National Community Pharmacists Association yesterday joined the National Association of Chain Drug Stores, National Association of Specialty Pharmacy, American Pharmacists Association, Food Marketing Institute, and National Grocers Association in calling on President Trump to address pharmacy DIR reform after CMS failed to finalize the agency’s proposal to reform pharmacy DIR fees this year. Further, in its comments on a separate rule proposing changes to safe harbor protections on drug rebates, NCPA emphasized fixing pharmacy DIR as among the “minimum requirements” needed to be addressed by the administration before the organization could support the proposal, given the significant questions surrounding how to operationalize the system the proposed rebate rule contemplates. The final rebate rule has moved to the Office of Management and Budget for review, the final step before it is released.

NCPA has worked to educate policymakers about pharmacy benefit manager business practices that harm small-business community pharmacies and the patients they serve. Since 2014, many of NCPA’s advocacy efforts have related specifically to pharmacy DIR. According to the Centers for Medicare and Medicaid Services, these pharmacy price concessions, net of all pharmacy incentive payments, have grown more than 45,000 percent between 2010 and 2017, which NCPA argues is why patients and pharmacies need reform and relief from DIR fees.


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing 22,000 pharmacies that employ 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America's most accessible health care providers. To learn more, visit