DIR fees

[VictorOfHungerGames]

Just read that 4000-5000 independent pharmacies are at risk of closing in the next five years due to DIR fees. Does that sound right?! I mean, I know PBMs are thieves and soon it will back fire and hoping they would pay the price but are DIR fees that high to a point of driving pharmacies out of business?

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[Wickett]

Just read that 4000-5000 independent pharmacies are at risk of closing in the next five years due to DIR fees. Does that sound right?! I mean, I know PBMs are thieves and soon it will back fire and hoping they would pay the price but are DIR fees that high to a point of driving pharmacies out of business?

My store is doing ok due to yearly script growth, but the DIR fees are continuing to climb at a really high rate. A couple years ago, they would charge us 4k or so a quarter in fees. This year it is up to 12k plus per quarter, on average. It can be frustrating to see our sales and gross profit be quite a bit up from last year, but be break even compared to the previous year due to DIR fees. If you are a smaller volume indie, that can quickly take you from profit to losing money.

 

[VictorOfHungerGames]

My store is doing ok due to yearly script growth, but the DIR fees are continuing to climb at a really high rate. A couple years ago, they would charge us 4k or so a quarter in fees. This year it is up to 12k plus per quarter, on average. It can be frustrating to see our sales and gross profit be quite a bit up from last year, but be break even compared to the previous year due to DIR fees. If you are a smaller volume indie, that can quickly take you from profit to losing money.

Does location matter? HEAT zones vs. non-HEAT zones?

 

[BenJammin]

No DIR fees if you don't accept insurance. Lots of physicians doing that but these dinguses are now trying to dispense out of their office

 

[projektreverb]

Does anyone know how they come up with the DIR fees?

 

[MilknCheerios]

Just read that 4000-5000 independent pharmacies are at risk of closing in the next five years due to DIR fees. Does that sound right?!

Do you have a source? That number sounds incredibly high. I don't work in an independent, but I know people that do, and they haven't mentioned anything about how much worse things have gotten.

 

[abrahamdrinkin]

Just read that 4000-5000 independent pharmacies are at risk of closing in the next five years due to DIR fees. Does that sound right?! I mean, I know PBMs are thieves and soon it will back fire and hoping they would pay the price but are DIR fees that high to a point of driving pharmacies out of business?

So....pharmacies won’t close “because of DIR” fees. If DIR fees go away, they’ll just remove that amount from the claim payment up front. I think that’s an important point money to make—I know people hate them but PBMs aren’t just gonna pony up that money if the loophole is closed. Also, aren’t DIR fees usually just on Medicare?

Does anyone know how they come up with the DIR fees?

It should stipulate in your contracts? Many are related to various performance parameters as I understand it...

 

[VictorOfHungerGames]

Do you have a source? That number sounds incredibly high. I don't work in an independent, but I know people that do, and they haven't mentioned anything about how much worse things have gotten.

Senate Finance Committee Wants Trump Action on DIR Fees

Eight pharmacy groups lauded a letter urging the Trump administration to reform direct and indirect remuneration (DIR) fees.

www.drugtopics.com

this was the article I was reading initially and stumbled on the article about pharmacies closing... can't find it now. Apparently there has been a 45,000% increase in DIR fees... wtf?! we just gonna roll over and play dead? PBMs need to be erased on the face of the earth.

 

[VictorOfHungerGames]

Does anyone know how they come up with the DIR fees?

These are very secretive fees which is why many are calling for transparency.