WASHINGTON, D.C. – U.S. Senators Shelley Moore Capito (R-W.Va.) and Jon Tester (D-Mont.) led a bipartisan group of colleagues in urging the administration to take immediate action on pharmacy direct and indirect remuneration (DIR) fee reforms to reduce prescription drug costs for Medicare beneficiaries. In a letter to President Donald Trump, the senators expressed disappointment that DIR reform was not included in the recently finalized Centers for Medicare & Medicaid Services (CMS) rule—despite being included in the proposed rule—and urged the administration to “move forward with efforts to deliver seniors real relief from rising prescription drug costs.”
“While we commend the administration for your goal to reduce seniors’ out of pocket costs for prescription drugs, we believe that finalizing [the Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Expenses] rule without including DIR reform is a missed opportunity to deliver real cost savings to Medicare beneficiaries. Without DIR reform, another year could pass before seniors see drug prices lowered at the pharmacy counter,” the senators write in the letter.
The letter was also signed by Senators James Inhofe (R-Okla.), Susan Collins (R-Maine), Tom Carper (D-Del.), Lisa Murkowski (R-Alaska), John Thune (R-S.D.), Roger Wicker (R-Miss.), John Boozman (R-Ark.), John Hoeven (R-N.D.), Joe Manchin (D-W.Va.), Jerry Moran (R-Kan.), Angus King (I-Maine), Bill Cassidy, MD (R-La.), Tom Cotton (R-Ark.), Steve Daines (R-Mont.), Joni Ernst (R-Iowa), Cory Gardner (R-Colo.), James Lankford (R-Okla.), David Perdue (R-Ga.), Mike Rounds (R-S.D.), Dan Sullivan (R-Alaska), John Kennedy (R-La.), Doug Jones (D-Ala.), Cindy Hyde-Smith (R-Miss.), Marsha Blackburn (R-Tenn.), Kevin Cramer (R-N.D.), and Maria Cantwell (D-Wash.).
The full letter is available here and below.
Dear Mr. President,
We write today to express our disappointment that the recently finalized Centers for Medicare & Medicaid Services (CMS) rule, Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out of Pocket Expenses (CMS-4180-F), failed to finalize the pharmacy direct and indirect remuneration (DIR) fee reform for plan year 2020, as included in CMS’s original proposal. While we commend the administration for your goal to reduce seniors’ out of pocket costs for prescription drugs, we believe that finalizing this rule without including DIR reform is a missed opportunity to deliver real cost savings to Medicare beneficiaries. Without DIR reform, another year could pass before seniors see drug prices lowered at the pharmacy counter.
As CMS itself cited in the proposed rule, DIR fees on pharmacies participating in Part D grew by 45,000 percent between 2010 and 2017. This increase is unacceptable and unsustainable, and creates uncertainty not only for community and specialty pharmacies but also for the patients who rely on Part D prescription drugs. Until pharmacy DIR fee reform occurs, seniors will continue to pay higher cost-sharing for their prescription drugs. CMS estimated that these reforms would have saved Medicare beneficiaries between $7.1 and $9.2 billion in cost sharing over the next ten years.
For these reasons, we continue to encourage the administration to move forward with efforts to deliver seniors real relief from rising prescription drug costs. We stand ready to work with you to determine how we can adopt this relief this year.
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