June 13, 2024


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NACDS applauds rule on DIR fee transparency


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Industry seeks additional comprehensive reforms

ARLINGTON, Va. — NACDS on Monday expressed appreciation for a new federal rule that will help to reduce seniors’ out-of-pocket prescription drug costs by improving transparency of exorbitant direct and indirect remuneration (DIR) fees imposed by payers on pharmacies. NACDS insists that comprehensive DIR fee reform now depends on further legislative and regulatory action to improve predictability, fairness, and viability for pharmacies. 

Steve Anderson

Steve Anderson


The new rule – Medicare Program; Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare Prescription Drug Benefit Programs – was finalized by the Centers for Medicare & Medicaid Services (CMS) on Friday. The rule’s provisions affecting DIR fees will take effect January 2024. 

NACDS president and CEO Steven Anderson said: “NACDS commends CMS for initiating long-overdue reform of these dire DIR fees in a way that will benefit seniors. It is critically important that there be no further delays. Further, NACDS calls on Congress and on CMS to accomplish swiftly the additional comprehensive reforms that are essential for pharmacy viability and for patient access. The pro-patient and pro-pharmacy work that remains includes the establishment of standardized pharmacy quality measures, which merits an immediate legislative remedy. 

“We appreciate that CMS finalized this rule, and improved the proposed rule according to some of NACDS’ recommendations in our comments. CMS took action to address transparency for all components of Medicare – including prescriptions filled for patients in the ‘coverage gap.’ It is vital for additional regulatory guardrails to be put into place and to prevent any unintended consequences that could harm patients and pharmacies alike. 

“NACDS also thanks the members of Congress, patient groups, provider groups, pharmacy allies, and others who have collaborated to bring to the forefront the extremely important issue of DIR fee reform. In advance, we thank you for your continued determination to build on this momentum. NACDS pays tribute to the diverse NACDS member companies of all formats and sizes that engaged with passion – particularly through the NACDS RxIMPACT grassroots advocacy program – to voice the need for DIR fee reform and to help make possible this achievement. Continued engagement, vigilance, and results will be crucial for seniors and for the pharmacies of all sizes and formats that serve them.” 


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