Dear APCI members,

A proposed regulation addressing DIR fees from the Centers for Medicare & Medicaid Services (CMS) has been the subject of much conversation in the pharmacy world. While APCI will be offering substantive written comments on the proposal, the co-op was thrilled to help organize and participate in a meeting between national pharmacy leaders and CMS Medicare leadership today.

APCI member Daryl Reynolds – a Georgia pharmacist and one of the owners of the U-Save-It group of pharmacies – spoke on the impact of DIR fees on patient access to medications and outcomes. He also discussed how DIR fees affect the sustainability of community pharmacy.

APCI Director of Public Policy and General Counsel Greg Reybold addressed how the PBMs’ use of DIR fees isn’t about lowering costs for patients at the counter – but rather how they are used to inflate prices at the counter for Part D beneficiaries to create revenue and reduce costs for the prescription drug plans and PBMs.

APCI urged CMS to closely scrutinize PBMs and their role in raising costs and to take more aggressive action to rein in DIR fees and other practices.

APCI offers a special thank you to Daryl Reynolds for stepping up on short notice to speak up on behalf of community pharmacists and their patients; he represented community pharmacy well. APCI also thanks CMS for organizing this call and their willingness to both tackle the issue of DIR fees and listen to the perspective of community pharmacy. We also want to thank NCPA and APhA for their substantive comments in today's session.

CMS is currently requesting public comments on their proposed regulation. If you would like to offer comments of your own, APCI will be providing talking points and a mechanism to submit your comments soon.