[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1227 Reported in Senate (RS)]

<DOC>





                                                       Calendar No. 131
116th CONGRESS
  1st Session
                                S. 1227

     To require the Federal Trade Commission to study the role of 
intermediaries in the pharmaceutical supply chain and provide Congress 
    with appropriate policy recommendations, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 29, 2019

 Mr. Grassley (for himself, Ms. Cantwell, Mr. Daines, Mr. Blumenthal, 
     Mr. Lankford, Ms. Ernst, Mr. Tillis, Mrs. Blackburn, and Mr. 
  Whitehouse) introduced the following bill; which was read twice and 
               referred to the Committee on the Judiciary

                June 28 (legislative day, June 27), 2019

               Reported by Mr. Graham, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL


 
     To require the Federal Trade Commission to study the role of 
intermediaries in the pharmaceutical supply chain and provide Congress 
    with appropriate policy recommendations, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Prescription Pricing for 
the People Act of 2019''.</DELETED>

<DELETED>SEC. 2. DEFINITIONS.</DELETED>

<DELETED>    In this Act:</DELETED>
        <DELETED>    (1) Appropriate committees of congress.--The term 
        ``appropriate committees of Congress'' means--</DELETED>
                <DELETED>    (A) the Committee on the Judiciary of the 
                Senate; and</DELETED>
                <DELETED>    (B) the Committee on the Judiciary of the 
                House of Representatives.</DELETED>
        <DELETED>    (2) Commission.--The term ``Commission'' means the 
        Federal Trade Commission.</DELETED>

<DELETED>SEC. 3. STUDY OF PHARMACEUTICAL SUPPLY CHAIN INTERMEDIARIES 
              AND MERGER ACTIVITY.</DELETED>

<DELETED>    (a) Report.--Not later than 1 year after the date of 
enactment of this Act, the Commission shall submit to the appropriate 
committees of Congress a report that--</DELETED>
        <DELETED>    (1) addresses at minimum--</DELETED>
                <DELETED>    (A) whether pharmacy benefit managers--
                </DELETED>
                        <DELETED>    (i) charge payers (including 
                        Medicare and Medicaid) a higher price than the 
                        reimbursement rate at which the pharmacy 
                        benefit managers reimburses competing 
                        pharmacies while reimbursing pharmacies in 
                        which the pharmacy benefit managers have an 
                        ownership interest at the rate charged to 
                        payers;</DELETED>
                        <DELETED>    (ii) steer patients to pharmacies 
                        in which the pharmacy benefit managers have an 
                        ownership interest;</DELETED>
                        <DELETED>    (iii) audit or review proprietary 
                        data, including acquisition costs, patient 
                        information, or dispensing information, of 
                        competing pharmacies that can be used for 
                        anticompetitive purposes; or</DELETED>
                        <DELETED>    (iv) use formulary designs to 
                        depress the market share of low-cost, lower-
                        rebate prescription drugs;</DELETED>
                <DELETED>    (B) the current state of competition in 
                the pharmaceutical supply chain, particularly with 
                regard to intermediaries and the recent vertical 
                integrations of pharmacy benefit managers with 
                insurance companies or other payers of prescription 
                drug benefits;</DELETED>
                <DELETED>    (C) how companies and payers assess the 
                benefits, costs, and risks of contracting with 
                intermediaries, including pharmacy services 
                administrative organizations, and whether more 
                information about the roles of intermediaries should be 
                available to consumers and payers; and</DELETED>
                <DELETED>    (D) whether there are any specific legal 
                or regulatory obstacles the Commission currently faces 
                in ensuring a competitive and transparent marketplace 
                in the pharmaceutical supply chain, including the 
                pharmacy benefit manager marketplace and pharmacy 
                services administrative organizations; and</DELETED>
        <DELETED>    (2) provides--</DELETED>
                <DELETED>    (A) observations or conclusions drawn from 
                the November 2017 roundtable entitled ``Understanding 
                Competition in Prescription Drug Markets: Entry and 
                Supply Chain Dynamics'', and any similar 
                efforts;</DELETED>
                <DELETED>    (B) specific actions the Commission 
                intends to take as a result of the November 2017 
                roundtable, and any similar efforts, including a 
                detailed description of relevant forthcoming actions, 
                additional research or roundtable discussions, consumer 
                education efforts, or enforcement actions; 
                and</DELETED>
                <DELETED>    (C) policy or legislative recommendations 
                to--</DELETED>
                        <DELETED>    (i) improve transparency and 
                        competition in the pharmaceutical supply 
                        chain;</DELETED>
                        <DELETED>    (ii) prevent and deter 
                        anticompetitive behavior in the pharmaceutical 
                        supply chain; and</DELETED>
                        <DELETED>    (iii) best ensure that consumers 
                        benefit from any cost savings or efficiencies 
                        that may result from mergers and 
                        consolidations.</DELETED>
<DELETED>    (b) Interim Report.--Not later than 180 days after the 
date of enactment of this Act, the Commission shall submit to the 
appropriate committees of Congress an interim report on the progress of 
the report required by subsection (a), along with preliminary findings 
and conclusions based on information collected to that date.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Prescription Pricing for the People 
Act of 2019''.

SEC. 2. DEFINITIONS.

    In this Act:
            (1) Appropriate committees of congress.--The term 
        ``appropriate committees of Congress'' means--
                    (A) the Committee on the Judiciary of the Senate; 
                and
                    (B) the Committee on the Judiciary of the House of 
                Representatives.
            (2) Commission.--The term ``Commission'' means the Federal 
        Trade Commission.

SEC. 3. STUDY OF PHARMACEUTICAL SUPPLY CHAIN INTERMEDIARIES AND MERGER 
              ACTIVITY.

    (a) Report.--Not later than 1 year after the date of enactment of 
this Act, the Commission shall submit to the appropriate committees of 
Congress a report that--
            (1) addresses at minimum--
                    (A) whether pharmacy benefit managers--
                            (i) charge payers a higher price than the 
                        reimbursement rate at which the pharmacy 
                        benefit managers reimburse pharmacies owned by 
                        the pharmacy benefit manager and pharmacies not 
                        owned by the pharmacy benefit manager;
                            (ii) steer patients for competitive 
                        advantage to any pharmacy, including a retail, 
                        mail-order, or any other type of pharmacy, in 
                        which the pharmacy benefit managers have an 
                        ownership interest;
                            (iii) audit or review proprietary data, 
                        including acquisition costs, patient 
                        information, or dispensing information, of 
                        pharmacies not owned by the pharmacy benefit 
                        manager and use such proprietary data to 
                        increase revenue or market share for 
                        competitive advantage; or
                            (iv) use formulary designs to increase the 
                        market share of higher cost prescription drugs 
                        or depress the market share of lower cost 
                        prescription drugs (each net of rebates and 
                        discounts);
                    (B) trends or observations on the state of 
                competition in the healthcare supply chain, 
                particularly with regard to intermediaries and their 
                integration with other intermediaries, suppliers, or 
                payers of prescription drug benefits;
                    (C) how companies and payers assess the benefits, 
                costs, and risks of contracting with intermediaries, 
                including pharmacy services administrative 
                organizations, and whether more information about the 
                roles of intermediaries should be available to 
                consumers and payers; and
                    (D) whether there are any specific legal or 
                regulatory obstacles the Commission currently faces in 
                enforcing the antitrust and consumer protection laws in 
                the pharmaceutical supply chain, including the pharmacy 
                benefit manager marketplace and pharmacy services 
                administrative organizations; and
            (2) provides--
                    (A) observations or conclusions drawn from the 
                November 2017 roundtable entitled ``Understanding 
                Competition in Prescription Drug Markets: Entry and 
                Supply Chain Dynamics,'' and any similar efforts;
                    (B) specific actions the Commission intends to take 
                as a result of the November 2017 roundtable, and any 
                similar efforts, including a detailed description of 
                relevant forthcoming actions, additional research or 
                roundtable discussions, consumer education efforts, or 
                enforcement actions; and
                    (C) policy or legislative recommendations to--
                            (i) improve transparency and competition in 
                        the pharmaceutical supply chain;
                            (ii) prevent and deter anticompetitive 
                        behavior in the pharmaceutical supply chain; 
                        and
                            (iii) best ensure that consumers benefit 
                        from any cost savings or efficiencies that may 
                        result from mergers and consolidations.
    (b) Interim Report.--Not later than 180 days after the date of 
enactment of this Act, the Commission shall submit to the appropriate 
committees of Congress an interim report on the progress of the report 
required by subsection (a), along with preliminary findings and 
conclusions based on information collected to that date.

SEC. 4. REPORT.

    The Commission shall submit to the appropriate committees of 
Congress a report that includes--
            (1) the number and nature of complaints received by the 
        Commission relating to an allegation of anticompetitive conduct 
        by a manufacturer of a sole-source drug;
            (2) the ability of the Commission to bring an enforcement 
        action against a manufacturer of a sole-source drug; and
            (3) policy or legislative recommendations to strengthen 
        enforcement actions relating to anticompetitive behavior.
                                                       Calendar No. 131

116th CONGRESS

  1st Session

                                S. 1227

_______________________________________________________________________

                                 A BILL

     To require the Federal Trade Commission to study the role of 
intermediaries in the pharmaceutical supply chain and provide Congress 
    with appropriate policy recommendations, and for other purposes.

_______________________________________________________________________

                June 28 (legislative day, June 27), 2019

                       Reported with an amendment