National LTC Pharmacy Advocacy Group: Explosion of PBM DIR Fees Squeezes Elderly Patients and LTC Pharmacies Who Serve Them

DATE: February 19, 2020

February 19, 2020

Washington, DC – The Senior Care Pharmacy Coalition (SCPC) today said a new analysis from XIL Consulting finding post-point-of-sale direct and indirect remuneration (DIR) transaction fees paid by pharmacies to pharmacy benefit managers (PBMs) and prescription drug plans (PDPs) rose by 1600% since 2013 helps renew attention on a previous CMS report finding DIR fees grew 45,000% from 2010-2017.

“This timely new report details yet another outlandish data point that should prompt renewed attention from lawmakers seeking to untangle the deceptive web of prescription drug pricing schemes employed by unaccountable middlemen,” stated Alan G. Rosenbloom, President and CEO of SCPC, the only Washington-based organization exclusively representing the interests of LTC pharmacies and the elderly patients they serve.

“It is our position that DIR fees are a windfall profit for PBMs and PDPs, and should be abolished – not reformed,” Rosenbloom continued. “The shocking continuation of astronomical DIR fee hikes throughout most of the past decade reiterates that elderly patients and the LTC pharmacies who serve them deserve systemic relief and reform.”

The SCPC President and CEO observed that DIR fees impact pharmacy markets differently, which drives different responses within the sector. “The unique nature of LTC pharmacies, the elderly patients they serve — and the fact they provide clinical and supportive services retail and other pharmacy groups do not — requires evaluating the regulatory landscape through a different, LTC pharmacy-specific prism,” he concluded.


The Senior Care Pharmacy Coalition (SCPC) is the only national organization exclusively representing the interests of LTC pharmacies. Its members operate in all 50 states and serve 850,000 patients daily in skilled nursing and assisted living facilities across the country. Visit to learn more.

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