DIR fees

Definition

Money a benefit manager takes back from the pharmacy weeks after a prescription is filled.

Why It Matters

They can turn an apparently profitable prescription into a loss weeks after it was filled, which makes gross reimbursement a number you cannot underwrite. Normalize earnings for them using the actual remittances rather than the seller's summary, and ask how the fees have moved over three years. A pharmacy whose margin depends on a fee schedule somebody else sets is carrying a risk no amount of dispensing volume fixes.