Published by the American Society of Health-System Pharmacists:

“To better understand direct and indirect remuneration (DIR) fees, pharmacists should learn how the fees relate to Medicare’s Star rating system, says Sandra Durley, associate director for ambulatory care pharmacy for the University of Illinois (UI) Hospital & Health Sciences System.”

Published by the Pharmacists United for Truth and Transparency:

“Dear PUTT Members,
If, like me, you found an unwelcome surprise in the form of a DIR Trimester 1 report statement in your mailbox, you aren’t alone. The PBM’s repugnant practice of arbitrarily reconciling contracts and reimbursements – then charging the rate differences back to us – is creating an environment of enormous unworkability, uncertainty and stress on the very industry whose mission and purpose is to provide patients with medicine to help heal or find relief when sick or in pain!”

Published by the American Pharmacy Purchasing Alliance:

“The rate of therapeutic drug use in the U.S. has steadily climbed over the years as more people fall ill and seek medical help. This increase should have resulted to a healthy economy among those in the pharmacy business, but what’s happening in real life is actually the opposite. Many independent pharmacies are struggling to make ends meet, and some even decide to close their doors since their losses are too great to recoup.”

Published by AmerisourceBergen:

“Direct and indirect remuneration (DIR) fees are wreaking havoc on balance sheets across community pharmacies, with many asking what can be done right now. It is reasonable to expect that pharmacy reimbursements are fair, accurate and timely, yet DIR fees are misleading, confusing and retroactive. This lack of transparency, as well as the resulting instability, threatens the viability of independent community pharmacies — and impacts patient access to medication.”

Published by Specialty Pharmacy Times:

“On behalf of NASP, I am writing to correct some misperceptions noted in the Specialty Pharmacy Times article citing the views of PCMA President and CEO Mark Merritt on Direct and Indirect Remuneration Fees. It is inaccurate to state that DIR Fees “don’t harm the health industry in any way; They only help it.” Unfortunately DIR Fees do harm the health industry, particularly as it relates to the negative impact on specialty pharmacy providers.”

Published by Drug Topics:

“Retail pharmacists are optimistic that Medicare direct and indirect remuneration (DIR) fees could end, if new bills proposed in the U.S. Senate and House are passed.

In mid-February, Senators Shelley Moore Capito (R-WV) and Jon Tester (D-MT) introduced legislation, Senate Bill 413, which would prohibit pharmacy DIR fees from being applied after the point-of-sale for prescription drugs dispensed to Medicare beneficiaries.”

Published by Avella:

“There has been a great deal of conversation in the healthcare industry recently surrounding direct and indirect remuneration, or “DIR” fees. These fees are charged to pharmacies by Pharmacy Benefit Managers (PBMs), and are causing a dramatic and negative impact to specialty pharmacies and the patients they serve.

This white paper details:

  • How criteria for assessing DIR fees is ill-fit for specialty pharmacies
  • How specialty pharmacies’ ability to care for vulnerable patients with complex medications is at risk due to these fees
  • How exceptionally expensive medication costs are being shifted to patients as a result of DIR fees
  • How the US healthcare system and government are also bearing the burden of these fees”

Published by The National Community Pharmacists Association:

“ALEXANDRIA, Va. (June 28, 2016) Most independent community pharmacists consistently encounter misleading and confusing fees imposed by prescription drug middlemen that negatively impact both pharmacies and patients and distort medication costs and reimbursement rates, according to a recent survey of 640 pharmacists conducted by the National Community Pharmacists Association (NCPA).”