The notion that the Pharmacy DIR Fees would not materially affect CVS Health’s or any other PBM’s profitability is probably true, but it does significantly impact the small margins independent pharmacies operate on. Let’s examine this tweet:
Take a moment to consider the patient. He is expected to pay a markup more than 16 times the cost of the prescription. And what if he doesn’t have the money? Then no medicine. Let’s look even closer. What did the pharmacy keep? $3.58. What did the PBM keep? $164.61. Now imagine getting a Pharmacy DIR Fee on $3.58
We at Keycentrix have no issue with everyone making a buck, but we do perceive an imbalance in the market. This imbalance is squeezing independent pharmacies out of high-touch and high-care transactions in an increasingly complicated payor landscape. Ultimately, in the end, this means there will be people underserved, and we can't see how that will improve patient outcomes. If Pharmacy DIR Fees are necessary, then let's reform them so they – at a minimum – are not a surprise.
Then again, what do we know? We just make great software.