[Congressional Record Volume 172, Number 49 (Wednesday, March 18, 2026)]
[Senate]
[Page S1284]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 4634. Mr. MERKLEY submitted an amendment intended to be proposed
by him to the bill S. 1383, to establish the Veterans Advisory
Committee on Equal Access, and for other purposes; which was ordered to
lie on the table; as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``End Price Gouging for
Medications Act''.
SEC. 2. REFERENCE PRICES FOR PRESCRIPTION DRUGS.
(a) Reference Prices.--The Secretary of Health and Human
Services (referred to in this section as the ``Secretary''),
in accordance with subsection (b), shall establish annual
reference prices for each prescription drug. Notwithstanding
any other provision of law, with respect to enrollees or
beneficiaries in any of the Federal health programs described
in subsection (c), the retail list price for a drug shall not
exceed the reference price for such drug.
(b) Criteria.--
(1) In general.--Each year, the Secretary shall establish
the reference price for each prescription drug under
subsection (a)--
(A) by determining the lowest retail list price for the
drug among the reference countries in which the drug is
available, if drug pricing information is available for at
least 3 of such countries; or
(B) in the case of a drug for which drug pricing
information or dosage equivalents are not available for at
least 3 of the reference countries, by determining an
appropriate price based on the Secretary's determination of--
(i) the added therapeutic effect of the drug;
(ii) the value of the drug;
(iii) patient access to the drug;
(iv) the costs associated with researching and developing
the drug; and
(v) other factors, as the Secretary determines appropriate.
(2) Reference countries.--For purposes of paragraph (1),
the reference countries are Australia, Austria, Belgium,
Canada, France, Germany, Italy, Japan, the Netherlands,
Sweden, Switzerland, and the United Kingdom.
(c) Federal Health Programs.--The reference prices
established under subsection (a) shall apply with respect to
covered inpatient and outpatient drugs under--
(1) the Medicare program under title XVIII of the Social
Security Act (42 U.S.C. 1395 et seq.);
(2) a State Medicaid plan under title XIX of the Social
Security Act (42 U.S.C. 1396 et seq.);
(3) the State Children's Health Insurance Program under
title XXI of the Social Security Act (42 U.S.C. 1397aa et
seq.);
(4) the TRICARE program under chapter 55 of title 10,
United States Code;
(5) hospital care and medical services furnished by the
Department of Veterans Affairs under chapters 17 and 18 of
title 38, United States Code;
(6) the Federal Employees Health Benefits Program
established under chapter 89 of title 5, United States Code;
and
(7) any health program, service, function, activity, or
facility funded, in whole or part, under the Indian Health
Care Improvement Act (25 U.S.C. 1601 et seq.), including
through direct or contract care provided under such Act or
through a contract or compact under the Indian Self-
Determination and Education Assistance Act (25 U.S.C. 5304 et
seq.).
(d) Applicability to Other Purchasers of Drugs.--
Notwithstanding any other provision of law, a drug
manufacturer shall offer prescription drugs at the reference
price to all individuals, including individuals who are not
insured and individuals who are covered under a group health
plan or group or individual health insurance coverage. In the
case of individuals covered by a group health plan or group
or individual health insurance coverage, such requirement is
met if the amount covered under such plan or coverage plus
the cost-sharing amount does not exceed the reference price.
(e) Enforcement.--
(1) Civil penalty.--A drug manufacturer who does not comply
with the requirements of subsection (a) 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 Federal health programs under
subsection (c) for the year; less
(B) the total amount the manufacturer would have received
for sales of the drug under such programs for the year if the
manufacturer had complied with subsection (a).
(2) Amounts collected.--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. The Director of the National Institutes of Health shall
use amounts so transferred for purposes of conducting drug
research and development.
(f) 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).
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