With the Centers for Medicare and Medicaid Services and the Community Oncology Alliance (COA) recently issuing reports about direct and indirect remuneration (DIR) fees, pharmacy benefit managers (PBMs) have come under fire.

These fees are retroactively charged to pharmacies who receive a bill weeks to months after a transaction. Pharmacies say that these fees harm their businesses, and affect their ability to stay in business and serve patients.

On the other hand, CVS Health has taken the position that these pay-for-performance fees do not impact their own profitability, since they are not recouping that much income from pharmacies. By making these statements, this particular PBM has made the case that DIR fees help drive down Medicare premiums and ensure that patients receive high quality care.

In an alleged leaked document from Mark Merritt, president and CEO of the Pharmaceutical Care Management Association (PCMA), the organization outlines strategies to combat potential reforms that will be placed on PBMs.

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