To the editor:

As the owner of Tanglewood Pharmacy, I’ve been serving the people of Stephenville for decades, and every time I fill a patient’s prescriptions, I see the harmful impact of DIR fees on our community and its citizens.

DC folks know DIR stands for direct and indirect remuneration. Around here, it just means money out of my pocket and higher costs for my patients.  DIR fees are the main reason many neighborhood pharmacies are forced to close their doors. Imposed on pharmacies, often retroactively, by large corporations known as Pharmacy Benefit Managers (PBMs), these fees keep me from predicting my future expenses - making it really tough to run a small business.

The only people benefitting from these fees are the PBMs. Out-of-pocket costs for prescription drugs continue to go up, and there is simply no transparency when it comes to the DIR clawbacks. The PBMs cannot and will not tell me how they arrive at their numbers, putting me, my patients, and our community in a bind – time after time.

What makes matters worse is there was a chance to fix this problem and the Administration failed to act. Now, we need Congress needs to take action. I was hopeful when I saw the recent letter from the Senate Committee on Finance, where lawmakers urged the Department of Health and Human Services to reform DIR fees – almost all of the committee members signed it, but I was disappointed to see that Texas Senator John Cornyn’s signature was not one of them.

Healthcare is like anything else, you get what you pay for, and frankly I can’t keep offering the services I do if I’m getting gouged by these DIR fees. Unless Senator Cornyn and the rest of the government wises up to the PBMs, local businesses and patients across Texas will continue to suffer.

Ed Horton,