,,ii  #aaeth ,,congress  #b;d ,session  
,s4 #cfhj  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,november #bi1 
#bjah ,mr4 ,merkley introduced the      
following bill2 which was read twice and
 referred to the ,committee on ,health1 
,education1 ,labor1 and ,pensions  ,a   
,,bill  ,to require the ,secretary of   
,health and ,human ,services to         
establish reference prices for          
prescription drugs for purposes of      
,federal health programs4  #a4 ,short   
title  ,this ,act may be cited as the   
,low ,drug ,prices ,act4  #b4 ,reference
 prices for prescription drugs  7a7     
,reference prices ,the ,secretary of    
,health and ,human ,services 7referred  
to in this section as the ,secretary71  
in accordance with subsection 7b71 shall
 establish annual reference prices for  
each prescription drug4 ,notwithstanding
 any other provision of law1 with       
respect to enrollees or beneficiaries in
 any of the ,federal health programs    
described in subsection 7c71 the total  

acquisition cost 7including the amount  
covered by the ,federal health program  
and any cost-sharing amount and taking  
into account any discount or rebate     
provided by the manufacturer7 for a drug
 shall not exceed the reference price   
for such drug4  7b7 ,criteria  7#a7 ,in 
general ,each year1 the ,secretary shall
 establish the reference price for each 
prescription drug under subsection 7a7  
by determining the median price for the 
drug among the reference countries4     
7#b7 ,reference countries ,for purposes 
of paragraph 7#a71 the reference        
countries are ,japan1 ,germany1 the     
,united ,kingdom1 ,france1 ,italy1      
,canada1 ,australia1 ,spain1 the        
,netherlands1 ,switzerland1 and ,sweden4
  7c7 ,federal health programs ,the     
reference prices established under      
subsection 7a7 shall apply with respect 
to covered inpatient and outpatient     
drugs under--  7#a7 the ,medicare       
program under title ,,xviii of the      
,social ,security ,act 7#db ,u4,s4,c4   

#acie et seq472  7#b7 a ,state ,medicaid
 plan under title ,,xix of the ,social  
,security ,act 7#db ,u4,s4,c4 #acif et  
seq472  7#c7 the ,state ,children's     
,health ,insurance ,program under title 
,,xxi of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acig;aa et seq472  7#d7 the 
,,tricare program under chapter #ee of  
title #aj1 ,united ,states ,code2  7#e7 
hospital care and medical services      
furnished by the ,department of         
,veterans ,affairs under chapters #ag   
and #ah of title #ch1 ,united ,states   
,code2  7#f7 the ,federal ,employees    
,health ,benefits ,program established  
under chapter #hi of title #e1 ,united  
,states ,code2 and  7#g7 any health     
program1 service1 function1 activity1 or
 facility funded1 in whole or part1     
under the ,indian ,health ,care         
,improvement ,act 7#be ,u4,s4,c4 #afja  
et seq471 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 7#be        
,u4,s4,c4 #ecjd et seq474  7d7          
,applicability to other purchasers of   
drugs ,notwithstanding any other        
provision of law1 as a condition for    
receiving reimbursements under any of   
the ,federal programs described in      
subsection 7c7 for any drug1 a drug     
manufacturer shall offer prescription   
drugs at the reference price to all     
individuals1 including individuals who  
are not insured and individuals who are 
covered under a group health plan or    
group or individual health insurance    
coverage4 ,in the case of individuals   
covered by a group health plan or group 
or individual health insurance coverage1
 such requirement is met if the amount  
covered under such plan or coverage plus
 the cost-sharing amount does not exceed
 the reference price4  7e7              
,applicability to brand and generic     
drugs ,the reference price established  
under subsection 7a7 shall apply to     
drugs approved under subsection 7c7 or  

7j7 of section #eje of the ,federal     
,food1 ,drug1 and ,cosmetic ,act 7#ba   
,u4,s4,c4 #cee7 or under subsection 7a7 
or 7k7 of section #cea of the ,public   
,health ,service ,act 7#db ,u4,s4,c4    
#bfb74