Rebecca Shanahan, JD, the CEO of Avella Specialty Pharmacy, in Phoenix, suggested that the dramatic change in hepatitis C virus (HCV)—from a life-threatening disease to a curable one—illustrates well the evolution of specialty pharmacy.
This opinion article featured in The Hill is authored by Rebecca Shanahan, CEO of Avella Specialty Pharmacy and President of the National Association of Specialty Pharmacy (NASP).
Medicare was created in 1966 as a promise to protect our seniors. But the security of aging Americans is increasingly threatened.
Here’s how Medicare Part D is supposed to work: seniors go to the pharmacy of their choosing, exchange their co-pay for medications, and pay a monthly premium toward a Part D insurance plan that is administered by a pharmacy benefit manager (PBM). Unfortunately, big PBMs — the private insurers who sell Medicare Part D plans to seniors — are rigging the system by imposing unfair “direct and indirect remuneration fees,” or DIR fees.
Calling on Centers for Medicare & Medicaid Services to Curb Below-Cost Reimbursement to Specialty Pharmacies by Pharmaceutical Benefit Managers, to Clarify Medicare Definitions, & Promote Accurate & Responsible Reimbursement
Direct & Indirect Remuneration (DIR) fees erode access to vital clinical services & breakthrough drugs for the most vulnerable Americans, increasing costs across the board & negatively impacting seniors & their caregivers, pharmacies, & taxpayers that fund Medicare
Last week, Frier Levitt, LLC; and the National Association of Specialty Pharmacy (NASP) published a white paper describing the advent and negative consequences of Direct and Indirect Remuneration (DIR) fees. America’s seniors need the Centers for Medicare and Medicaid Services (CMS) to take immediate action to stop Pharmaceutical Benefits Managers (PBMs) from levying inappropriate, unreasonable and unsustainable DIR fees on specialty pharmacies.
For many patients with rare diseases, reaching the first step of an accurate diagnosis can be a lengthy journey, riddled with pain, difficulty, and trial and error—and that’s before they begin the challenge of fighting and treating their conditions.
Once diagnosed, patients with rare diseases often face a new set of challenges: affordability, adherence to complex regimens, side effect management, and coordination of follow-up appointments that may involve providers far from home. And yet, innovative therapies are emerging that offer patients, including those who had previously exhausted all other options, new opportunities for improved health outcomes.