2024 isn’t a happy new year when it comes to the Direct and Indirect Remuneration (DIR) fees.
DIR fees are price concessions that are negotiated between PBMs and pharmacies that participate in Medicare Part D networks. As one white paper shows, DIR fees can already drastically reduce your pharmacy’s profit margins. Yet effective January 1, pharmacies now pay twice the amount of DIR fees: both retrospective DIR fees from 2023 and point-of-sale fees for the current year.
The final rule from CMS merely moves the fees to the point-of-sale negotiated price but does not eliminate the fees. Although the pharmacy community has consistently pushed for the elimination of retroactive DIR fees, the final ruling still creates some uncertainty and financial impacts on pharmacies. CMS acknowledges the possibility that changes in cash flow may cause some already struggling pharmacies to decrease services or medication availability, and/or be unable to remain in business, which may impact pharmacy networks.*
Talk to SureCost about offsetting the burden of DIR fees.
The fluctuations in product costs affect how much your pharmacy charges for products, which forces patients to shop for better prices. Pharmacies lose patients, and the competition between them just gets harder. It all amounts to negative impacts on your pharmacy’s cash flow.
Pharmacies are already scrambling to offset these DIR costs. In an NCPA survey, 64% of respondents said they were putting aside cash for their estimated DIR fees. 42% applied for loans, while 23% paid consultants. We also know from current customers that these DIR fees can range from 2%-8%+ of their revenues.
All of these approaches involve pharmacies taking money away from their business. To offset the burden of DIR fees while staying competitive, your pharmacy needs to save money.
Fortunately, by leveraging smarter purchasing, you can consistently find the best purchasing options for your patients and your business. You’ll save more, drive compliance, and increase efficiency. You’ll also overcome the DIR “hangover.” Read more >
