NCPA: Final Rule Improves Transparency; Protections for Patients and Pharmacies Still Needed

NCPA May 2, 2022

ALEXANDRIA, Va. (May 2, 2022) – The National Community Pharmacists Association says the Biden administration’s decision to advance reforms to controversial, backdoor price concessions that increase patient drug costs is welcome progress, but delaying implementation until 2024 is a missed opportunity for patients and pharmacies.  

Fixing pharmacy DIR fees has been NCPA’s top advocacy priority for years. NCPA has worked with Congress and previous administrations to minimize or eliminate pharmacy DIR fees. In 2021, NCPA also filed federal litigation to remedy the problem.

“There is overwhelming bipartisan support for swiftly reforming pharmacy DIR fees,” says NCPA CEO B. Douglas Hoey, pharmacist, MBA. “We’ve worked hard over the years to build that support among policymakers and grow our stable of allies across industries who understand exactly how these fees shake down seniors and local community pharmacies. And we thank the administration for moving to increase transparency so our members can soon know up front what their lowest reimbursement would be.

“However, we’re disappointed that PBMs and their insurer-partners/owners have been given another year to manipulate the system and continue charging higher costs to seniors. Further, the final rule does not prohibit PBM contract terms that allow for penalty payments after prescriptions leave the pharmacy; therefore, retroactive penalties could still occur.  

“CMS must close this loophole to accomplish the meaningful pharmacy DIR reform that so many of us have been fighting for.”


Founded in 1898, the National Community Pharmacists Association is the voice for the community pharmacist, representing nearly 19,400 pharmacies that employ approximately 215,000 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