Available Until 4/6/2024

Demystifying DIR Fees

Planned in cooperation with the ASHP Section of Specialty Pharmacy Practitioners

ACPE Activity Number: 0204-0000-21-019-H04-P, 0204-0000-21-019-H04-T

Activity Date: April 6, 2021
Expiration Date: April 6, 2024
Activity Type: Knowledge-based  
CE Credits: 1.0 hour, no partial credit
Activity Fee: Members – Free / Non-Member – Not Available

 This activity is a recording from a live webinar and those that claim credit for the live webinar should not claim credit for this activity.

Activity Overview

Direct and indirect renumeration fees (DIR) are growing at an alarming rate. Many health system outpatient pharmacies are negatively impacted and may have little understanding of what they are or how to plan for them. This webinar will review the history of DIR fees, how they are calculated, mitigation strategies, budget planning and how members can get involved in advocacy efforts.


The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Target Audience

This activity was planned to meet the educational needs of health system outpatient and speciatly pharmacy leaders, pharmacists and pharmacy technicians.

Learning Objectives

  1. Discuss the history of DIR fees and what they are.
  2. Describe the impacts DIR fees have on health system outpatient and speciatly pharmacies.
  3. Explain strategies to plan for DIR fees in the budget.

Schedule of Activities

  • Introduction and Announcements
  • Presentation
  • Questions, Answers, and Discussion


  • Kristine Crawford, Pharm.D., Specialty Pharmacy Manager, Virginia Mason Medical Center, Seattle, WA
  • Sydney Kchao, Pharm.D., M.S., Assistant Director of Pharmacy, Finance, Emory University Hospital Midtown, Atlanta, GA
  • Denise Scarpelli, Pharm.D., Executive Director, Ambulatory Pharmacy Business and Development, University of Chicago Medicine, Chicago, IL
  • Hung Trong, Pharm.D., M.B.A., Administrative Director, Virginia Mason Medical Center, Seattle, WA
  • Moderator: Travis Hunerdosse, Pharm.D., M.B.A., Senior Director Pharmacy Networks, Vizient, Chicago IL


In accordance with the ACPE's and ACCME's Standards for Commercial Support, anyone in a position to control the content of an educational activity is required to disclose to the accredited provider their relevant financial relationships. In accordance with these Standards, all potential conflicts of interest have been resolved. An individual has a relevant financial relationship if he or she (or spouse/domestic partner) has a financial relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the activity content over which the individual has control.

As defined by ACCME, a commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The Standards for Commercial Support do not consider providers of clinical service directly to patients to be commercial interests. The existence or non-existence of relevant financial relationships will be disclosed to the activity audience. All identified conflicts of interest must be resolved prior to the activity.

  • All planners, presenters, reviewers, and ASHP staff report no financial relationships relevant to this activity. 

Methods and CE Requirements

This activity consists of a recordings of faculty slides presentations, active learning activities, discussion, and handouts. Participants must participate in the activity in its entirety to claim continuing pharmacy education credit online at ASHP eLearning Portal. Follow the prompts online to complete the evaluation, claim credit and view the statement of credit immediately after completing the activity.

Per ACPE requirements, CPE credit must be claimed within 60 days of being earned. Claim your CE at http://elearning.ashp.org. Once you have processed and claimed your CE credit, we encourage you to check your NABP eProfile account to verify your credits were transferred successfully before the ACPE 60-day deadline. It is an electronic direct-report process so your credits should appear in your account within a few minutes. After the 60 day deadline, ASHP will no longer be able to report your credit(s) for this activity.