David Stanley recently contributed in the Modern Medicine Networking on how, "PBMs Pay Less Each Year While Prices Go Up".
"Most of you are familiar with Medicare Part D direct and indirect remuneration (DIR) fees and know them as just another headache that comes along with your PBM contract. In a nutshell, when a DIR fee is collected, the price you see when you file a drug claim is not the amount your pharmacy will receive. When the next statement from the PBM comes, you’ll notice an amount has been deducted from what you saw when the prescription was filled. Why? If you have a few hours (or days) to comb over your PBM contracts you may be able to figure it out. Most of us don’t have that time though, so these DIR fees have the practical effect of making managing cash flow and budgeting even more challenging."