Grassley, Wyden Introduce Major Prescription Drug Pricing Reform to Lower Costs for Americans
* * *
- Legislation Modernizes, Improves Medicare Part B, Part D and Medicaid
- Bill Saves Taxpayers More Than
- Commercial Market Also Sees Lower Costs
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"The cost of many prescription drugs is too high. Without action, we're on an unsustainable path for taxpayers, seniors and all Americans. A working class family shouldn't have to pick between making their rent or mortgage payment and being able to afford their kids' medications. A single mother with diabetes shouldn't have to pick between groceries and insulin. A senior citizen who's paid into the system their entire life shouldn't have to cut pills in half to be able to make it to the next refill. The time to act on prescription drug prices is now," Grassley and Wyden said.
"We've been working on a bipartisan basis for more than six months to craft legislation that begins to address the broken prescription drug supply chain. Pharmaceutical companies play a vital role in creating new and innovative medicines that save and improve the quality of millions of American lives, but that doesn't help Americans who can't afford them. Similarly, pharmacy benefit managers and insurance companies have the opportunity to negotiate lower prices, but the American people don't know how much these middlemen pocket for themselves. This legislation shows that no industry is above accountability. Passing these reforms, especially those that will affect some of the most entrenched interests in
* Taxpayers save
* Beneficiaries save
* Beneficiaries save
* Taxpayers save
* Americans in the commercial market would see savings: The inflation-rebate provision would reduce costs for prescription drug benefits offered by commercial insurance plans and the redesign provision would not have a substantial effect on prescription drug benefits offered by commercial insurance plans.
Details of the legislation can be found below. Text of the chairman's mark can be found HERE (https://www.finance.senate.gov/imo/media/doc/FINAL%20Description%20of%20the%20Chairman's%20Mark%20for%20the%20Prescription%20Drug%20Pricing%20Reduction%20Act%20of%202019.pdf).
Medicare:
* Modernize and improve the successful Part D program by:
- Simplifying the program's design;
- Protecting beneficiaries with high costs and providing peace of mind through an on out-of-pocket spending cap;
- Improving incentives to increase negotiation between prescription drug plans and manufacturers;
- Protecting the program from rampant manufacturer drug price increases; and
Benefiting patients and taxpayers through lower government spending, premiums, and out-of-pocket costs.
* Increase transparency into pharmacy benefit manager (PBM) practices and manufacturer drug pricing decisions;
* Improve how Medicare calculates Part B prescription drug payment amounts to lower spending and beneficiary out-of-pocket costs; and
* Eliminate excess Part B drug payments that drive up beneficiary and program costs.
Medicaid:
* Increase transparency and make manufacturers more accountable to federal taxpayers;
* Allow Medicaid to pay for gene therapies for rare disease through new risk-sharing value-based agreements, which will increase access to life-saving, miracle treatments for the most vulnerable;
* Apply pressure on manufacturers to lower list prices and report more accurate calculations of their rebate obligations; and
* Prevent spread pricing and gaming in the Medicaid program by PBMs to ensure that beneficiaries, states and the federal government are getting the best deal possible.
OPEN EXECUTIVE SESSION
Notice
The Chairman wishes to inform Members that the
The Chairman requests that an electronic copy and at least 1 hardcopy of each amendment be filed with the Chief Clerk,
The Congressional Budget Analysis will be distributed at a later date.
The Chairman urges every Member to attend.


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