Independent Pharmacists Blanket Congress with Letters on Pharmacy DIR Reform

So far nearly 4,600 letters sent to Congress supporting DIR reform bill

NCPA July 7, 2021

ALEXANDRIA, Va. (July 7, 2021) – Congress has been buried in letters from members of the National Community Pharmacists Association, a group representing more than 21,000 independent pharmacies, urging passage of legislation to stop the abuse of backdoor fees that have increased by 91,500 percent in recent years.

“We know there is strong bipartisan support for reforming pharmacy DIR fees,” said B. Douglas Hoey, NCPA’s CEO. “Now we must translate that support into action.”

NCPA launched a grassroots campaign four weeks ago urging members to contact their congressional representatives in support of S. 1909/H.R. 3554. The Pharmacy DIR Reform to Reduce Senior Drug Costs Act would overhaul the way pharmacy benefit managers apply price concessions on local pharmacies.

Currently, pharmacies find out how much pharmacy benefit managers and insurance plans will charge the patient and how much the pharmacy will be reimbursed while the patient waits for their medicine. But many weeks later, the PBM reneges on the amount it said would pay the pharmacy and may take back tens of thousands of dollars long after the point of sale. According to CMS, the concessions, known as pharmacy DIR fees, have risen 91,500 percent in recent years. The fees drive up out-of-pocket costs for seniors and other patients. They’re driving local pharmacies out of business, and they do nothing to improve health care outcomes.

“It’s a shakedown of senior citizens and their local health care providers,” said Hoey. “This is an urgent situation. The same pharmacies that have been crucial in national fight against COVID-19 are in danger of disappearing before the next public health emergency. Congress must act now.”

In the last month, 1,634 community pharmacy advocates have sent almost 4,600 letters to members of Congress in support of reform. On June 17, NCPA and several other groups delivered a letter of support to Congress with 249 signatories, including organizations representing national and state pharmacy groups, consumer groups, thousands of grocery stores with pharmacies, and even the National Federation of Independent Business, which is the country’s leading small business advocate.

“Support for reform is overwhelming and bipartisan,” said Hoey. “We’re pulling out all the stops to make that loud and clear to every member of Congress.”

To contact legislators in favor of the Pharmacy DIR Reform to Reduce Senior Drug Costs Act, click here.


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing over 21,000 pharmacies that employ approximately 250,000 individuals nationwide. Community pharmacies are rooted in the communities where they are located and are among America’s most accessible health care providers. To learn more, visit