[Congressional Record Volume 170, Number 115 (Thursday, July 11, 2024)]
[Senate]
[Pages S5020-S5021]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 2726. Mr. MERKLEY (for himself and Mr. Welch) submitted an 
amendment intended to be proposed by him to the bill S. 4638, to 
authorize appropriations for fiscal year 2025 for military activities 
of the Department of Defense, for military construction, and for 
defense activities of the Department of Energy, to prescribe military 
personnel strengths for such fiscal year, and for other purposes; which 
was ordered to lie on the table; as follows:

        At the appropriate place in title VII, insert the 
     following:

     SEC. 7__. REFERENCE PRICES FOR PRESCRIPTION DRUGS UNDER THE 
                   TRICARE PROGRAM.

       (a) In General.--Each year, the Secretary of Defense shall 
     establish the reference price for each prescription drug 
     provided to beneficiaries under the TRICARE program--
       (1) by determining the lowest retail list price for the 
     drug among the countries specified in subsection (b) in which 
     the drug is available, if drug pricing information is 
     available for at least 3 of such countries; or
       (2) in the case of a drug for which drug pricing 
     information or dosage equivalents are not available for at 
     least 3 of such countries, by determining an appropriate 
     price based on the determination by the Secretary of--
       (A) the added therapeutic effect of the drug;
       (B) the value of the drug;
       (C) patient access to the drug;

[[Page S5021]]

       (D) the costs associated with researching and developing 
     the drug; and
       (E) other factors, as the Secretary determines appropriate.
       (b) Reference Countries.--The countries specified in this 
     subsection are Japan, Germany, the United Kingdom, France, 
     Italy, Canada, Australia, Spain, the Netherlands, 
     Switzerland, and Sweden.
       (c) Application Under TRICARE Program.--
       (1) Federal supply schedule.--In procuring a prescription 
     drug under the Federal Supply Schedule of the General 
     Services Administration, the Secretary of Defense, and any 
     drug manufacturer providing the prescription drug to the 
     Secretary, shall comply with the price limitations under 
     section 8126 of title 38, United States Code, or the 
     reference price limitations for such drug established under 
     subsection (a), whichever is lower.
       (2) Contracts with pharmacy benefits managers.--
       (A) In general.--In entering into contracts with pharmacy 
     benefits managers to carry out the pharmacy benefits program 
     under section 1074g of title 10, United States Code, the 
     Secretary of Defense shall ensure that the price for 
     prescription drugs provided by such pharmacy benefits 
     managers to beneficiaries under the TRICARE program does not 
     exceed the price for such drug established under the pharmacy 
     benefits program or the reference price for such drug 
     established under subsection (a), whichever is lower.
       (B) Drug manufacturers.--A drug manufacturer may not sell a 
     prescription drug under the pharmacy benefits program under 
     section 1074g of title 10, United States Code, for an amount 
     that exceeds the limitation under subparagraph (A).
       (3) Direct purchasing.--
       (A) In general.--In making direct purchases of prescription 
     drugs under any authority not covered by paragraph (1) or 
     (2), the Secretary of Defense shall ensure that the price for 
     such drug does not exceed the reference price for such drug 
     established under subsection (a).
       (B) Drug manufacturers.--A drug manufacturer may not sell a 
     prescription drug to the Secretary of Defense under an 
     authority specified in subparagraph (A) for an amount that 
     exceeds the reference price for such drug established under 
     subsection (a).
       (d) Enforcement.--
       (1) Civil penalty.--A drug manufacturer who does not comply 
     with the requirements under subsection (c) shall be subject 
     to a civil penalty, for each year in which the violation 
     occurs and with respect to each drug for which the violation 
     occurs, in an amount equal to 5 times the difference 
     between--
       (A) the total amount received by the manufacturer for sales 
     of the drug under the TRICARE program for the year; less
       (B) the total amount the manufacturer would have received 
     for sales of the drug under the TRICARE program for the year 
     if the manufacturer had complied with subsection (c).
       (2) Amounts collected.--
       (A) In general.--Each year, the Secretary of the Treasury 
     shall transfer to the Director of the National Institutes of 
     Health an amount equal to the amount collected in civil 
     penalties under subsection (e) for the previous year.
       (B) Use of amounts.--The Director of the National 
     Institutes of Health shall use amounts transferred under 
     subparagraph (A) for purposes of conducting drug research and 
     development.
       (e) Applicability to Brand and Generic Drugs.--The 
     reference price established under subsection (a) shall apply 
     to drugs approved under subsection (c) or (j) of section 505 
     of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355) 
     or under subsection (a) or (k) of section 351 of the Public 
     Health Service Act (42 U.S.C. 262).
       (f) TRICARE Program Defined.--In this section, the term 
     ``TRICARE program'' has the meaning given that term in 
     section 1072 of title 10, United States Code.
                                 ______