The NCPA annual survey served up some interesting, but by no means surprising, nuggets. Complaints about DIR fees ranked top on the list of issues that registered concern among pharmacists. Douglas Hoey, NCPA CEO cited other top priorities like “long-standing, PBM-generated challenges” of transparency and preferred pharmacy designations and their impact on independent pharmacists. The Eighth Circuit hasn’t provided much hope, either. It recently handed an appellate decision in Pharmaceutical Care Management Association v. Gerhart to PCMA, effectively describing the much-sought-after transparency pharmacy advocates are pushing as “interference” under ERISA (The Employee Retirement Income Security Act). It was not a good day for independent pharmacy.