Mike Collins: “Before the gentleman goes, you told the story about getting a call from your own pharmacist. You and I were here…”

“Before the gentleman goes, you told the story about getting a call from your own pharmacist. You and I were here together, I think, sometime 6 months ago. We were doing this and talking about this issue of mail order. We were talking about this. I had a Member who was watching us on the floor talk about the pharmacy and the PBM problem and got a call from the PBM because they had gotten a prescription for their child. Yes, the day before they are getting a call in their office from the PBM saying: If you just switch from your local pharmacist, we will do it better. That is why we are sitting here. An interesting thing you brought up on DIR fees. What we have right here sort of describes what you were talking about. I am putting it here so people can see it. There is an interesting part of this DIR fee issue. It forces Medicare part D beneficiaries to pay inflated prices at the point of sale that are higher in actual cost than the drugs. The cost of the drug will be recouped in DIR fees, which is retroactively assessed later. Many beneficiaries are moving past their part D benefit faster and hitting the doughnut hole sooner, forcing them to pay out-of-pocket costs. This is particularly true with lifesaving or specialty drugs. These are things that we are seeing. Patients forced to pay out of pocket might be forced to cut back or abandon treatment. According to the Community Oncology Alliance, pharmacists lose $58,000 per practice, on average, to DIR fees each year.…”