Patients, Government Face Increasing Healthcare Costs With DIR Fees, Rep. Collins Said

Conferences > NCODA Spring Forum 2018 – Published on: March 02, 2018
Patients, Government Face Increasing Healthcare Costs With DIR Fees, Rep. Collins Said
Laura Joszt
Coverage from the National Community Oncology Dispensing Association Spring Forum 2018.
Direct and indirect remuneration (DIR) fees have been a growing concern for community pharmacists, and pharmacists who haven’t had an issue with them yet will run into them soon, said Representative Doug Collins, R-Georgia, who was the keynote speaker at the National Community Oncology Dispensing Association Spring Forum 2018, held March 1-3 in Dallas, Texas.

Collins focused his discussion on DIR fees and how they are increasing costs for the patient—by pushing them into the donut hole and catastrophic coverage in Medicare—and for the healthcare system. In addition, since Medicare patients are being pushed into catastrophic coverage, CMS has to pick up the extra costs, which means the taxpayer is spending more.

In general, DIR fees to pharmacy benefit managers (PBMs) are driving up costs, and Collins said research has found that the average community pharmacist loses $83,000 a year on DIR fees alone. The problem is that the industry is on track for a situation where PBMs begin to either kill off community pharmacies or they buy other PBMs and consolidate even further.

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Laura Joszt