In the community…


Report visiting a pharmacist in the past 12 months.

In policy…


Agree that change is needed in rules that result in below cost or unpredictable reimbursement from payers to pharmacies.

National poll of 1,995 registered voters, conducted January 4-6, 2019, by Morning Consult and commissioned by NACDS (margin of error +/- 2%).


Community pharmacies serve as convenient and critical access points for patient care. Considering the value of pharmacy in the healthcare delivery system, it is critical to support policies that preserve Medicaid, Medicare, and commercially insured patient access to pharmacy benefits and services that generate savings for all payers.

The value of community pharmacy in delivering high quality care at an overall lower cost should be recognized in the development of healthcare policies.

CMS should use its authority to include pharmacy DIR fee reform in Modernizing Part D and Medicare Advantage to Lower Prices and Reduce Out-of-Pocket Expenses. Failure to act on DIR reform will risk beneficiary health through reduced access to prescription drugs and reduced medication adherence, which raises other healthcare costs.

The abuses and harms of pharmacy DIR fees are genuine – DIR fees are being misused by payers to claw back reimbursement paid to pharmacies for prescriptions filled for Medicare beneficiaries. The harmful effects of current DIR practices on Medicare beneficiaries, pharmacies, and competition would be cut down by implementing reforms to eliminate pharmacy DIR fees.

Implementing DIR fee reform, coupled with a pharmacy quality incentive program, will lower out-of-pockets costs for patients and make medicine more accessible, leading to greater adherence and better health outcomes through services such as medication optimization.

Community pharmacy is committed to providing pharmacist care for TRICARE patients in a way that will also lead to savings for the Department of Defense. Pharmacies improve patient outcomes through many cost-saving services: medication adherence; access to health tests; managing chronic conditions; immunizations; and helping to combat the opioid abuse crisis.

Discover more information about NACDS’ long-standing advocacy for direct and indirect remuneration [DIR] fee reform.


People trust pharmacies for answers in times of need. We want to help provide quality, collaborative policy solutions, just like we provide health and wellness solutions to millions of patients and consumers every day.

2019 Pharmacy Opinion Research