Ban Spread Pricing and End DIR Fees in Budget Reconciliation, Community Pharmacy Urges

Reforms have bipartisan support and would save seniors and the federal government, NCPA says

NCPA September 1, 2021

ALEXANDRIA, Va. (Sept. 1, 2021) – The National Community Pharmacists Association strongly supports the inclusion of language to reform pharmacy direct and indirect remuneration fees in Medicare Part D and eliminate spread pricing in Medicaid managed care within the budget reconciliation package being developed by policymakers. Karry La Violette, NCPA Senior Vice President of Government Affairs, emphasized to top negotiators that pharmacy DIR fee reform would save seniors an estimated $7-9 billion and a ban on Medicaid managed care spread pricing would save the federal government over $1 billion.

La Violette says, “President Biden and other policymakers have called for lower drug prices for seniors. The budget reconciliation process provides an opportunity to help accomplish that by ending pharmacy DIR fees, and to also save the government itself some money by eliminating pharmacy benefit managers’ egregious spread pricing tactics. Both reforms have earned significant bipartisan support, and we strongly urge Majority Leader Schumer, Speaker Pelosi, Chairman Wyden, and Chairman Pallone to include them in the final package.”

Click for La Violette’s letter to Senate Majority Leader Charles Schumer (D-N.Y.), House Speaker Nancy Pelosi (D-Calif.), Senate Finance Committee Chairman Ron Wyden (D-Ore.), and House Energy and Commerce Committee Chairman Frank Pallone (D-N.J.). 


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