DIR fees refer to the money pharmacy benefit managers collect to offset Medicare Part D member costs. These fees increased by 45,000 percent between 2010-17, according to CMS
Mr. Hoey’s letter argues that DIR fees increase prescription drug costs and force some community pharmacists to shut down their pharmacies, leaving many seniors without access to their medication.
“[DIR fees] are not only bad for seniors but are also detrimental to taxpayers and neighborhood pharmacies,” Mr. Hoey wrote. “If policymakers were to change the current policy and end the secretive rebate game without also reforming pharmacy DIR, there is no doubt in my mind that PBMs will maneuver to leverage even more DIR fees to make up the difference.”
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