Prescription Drug Pricing Dashboard Act

II 117TH CONGRESS 1ST SESSION S. 1773 To amend title XI of the Social Security Act to establish internet website- based dashboards to allow the public to review information on spending for, and utilization of, prescription drugs and biologicals covered under the Medicare and Medicaid programs. IN THE SENATE OF THE UNITED STATES MAY 20, 2021 Mr. CASEY (for himself and Ms. COLLINS) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XI of the Social Security Act to establish internet website-based dashboards to allow the public to review information on spending for, and utilization of, prescription drugs and biologicals covered under the Medicare and Medicaid programs. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Prescription Drug 4 Pricing Dashboard Act’’. 5 VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1773 IS SEC. 2. PRESCRIPTION DRUG PRICING DASHBOARDS. 1 Part A of title XI of the Social Security Act is 2 amended by adding at the end the following new section: 3 ‘‘SEC. 1150D. PRESCRIPTION DRUG PRICING DASHBOARDS. 4 ‘‘(a) IN GENERAL.—Beginning not later than Janu- 5 ary 1, 2022, the Secretary shall establish, and annually 6 update, internet website-based dashboards, through which 7 beneficiaries, clinicians, researchers, and the public can re- 8 view information on spending for, and utilization of, pre- 9 scription drugs and biologicals (and related supplies and 10 mechanisms of delivery) covered under each of parts B 11 and D of title XVIII and under a State program under 12 title XIX, including information on trends of such spend- 13 ing and utilization over time. 14 ‘‘(b) MEDICARE PART B DRUG AND BIOLOGICAL 15 DASHBOARD.— 16 ‘‘(1) IN GENERAL.—The dashboard established 17 under subsection (a) for part B of title XVIII shall 18 provide the information described in paragraph (2). 19 ‘‘(2) INFORMATION DESCRIBED.—The informa- 20 tion described in this paragraph is the following in- 21 formation with respect to drug or biologicals covered 22 under such part B: 23 ‘‘(A) The brand name and, if applicable, 24 the generic names of the drug or biological. 25 VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1773 IS ‘‘(B) Consumer-friendly information on the 1 uses and clinical indications of the drug or bio- 2 logical. 3 ‘‘(C) The manufacturer or labeler of the 4 drug or biological. 5 ‘‘(D) To the extent feasible, the following 6 information: 7 ‘‘(i) Average total spending per dos- 8 age unit of the drug or biological in the 9 most recent 2 calendar years for which 10 data is available. 11 ‘‘(ii) The percentage change in aver- 12 age spending on the drug or biological per 13 dosage unit between the most recent cal- 14 endar year for which data is available 15 and— 16 ‘‘(I) the preceding calendar year; 17 and 18 ‘‘(II) the preceding 5 and 10 cal- 19 endar years. 20 ‘‘(iii) The annual growth rate in aver- 21 age spending per dosage unit of the drug 22 or biological in the most recent 5 or 10 23 calendar years for which data is available. 24 VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1773 IS ‘‘(iv) Total spending for the drug or 1 biological for the most recent calendar year 2 for which data is available. 3 ‘‘(v) The number of beneficiaries re- 4 ceiving the drug or biological in the most 5 recent calendar year for which data is 6 available. 7 ‘‘(vi) Average spending on the drug 8 per beneficiary for the most recent cal- 9 endar year for which data is available. 10 ‘‘(E) The average sales price of the drug 11 or biological (as determined under section 12 1847A) for the most recent quarter. 13 ‘‘(F) Consumer-friendly information about 14 the coinsurance amount for the drug or biologi- 15 cal for beneficiaries for the most recent quarter. 16 Such information shall not include coinsurance 17 amounts for qualified medicare beneficiaries (as 18 defined in section 1905(p)(1)). 19 ‘‘(G) For the most recent calendar year for 20 which data is available— 21 ‘‘(i) the 15 drugs and biologicals with 22 the highest total spending under such part; 23 and 24 VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1773 IS ‘‘(ii) any drug or biological for which 1 the average annual per beneficiary spend- 2 ing exceeds the gross spending for covered 3 part D drugs at which the annual out-of- 4 pocket threshold under section 1860D– 5 2(b)(4)(B) would be met for the year. 6 ‘‘(H) Other information (not otherwise 7 prohibited in law from being disclosed) that the 8 Secretary determines would provide bene- 9 ficiaries, clinicians, researchers, and the public 10 with helpful information about drug and bio- 11 logical spending and utilization (including 12 trends of such spending and utilization). 13 ‘‘(c) MEDICARE COVERED PART D DRUG DASH- 14 BOARD.— 15 ‘‘(1) IN GENERAL.—The dashboard established 16 under subsection (a) for part D of title XVIII shall 17 provide the information described in paragraph (2). 18 ‘‘(2) INFORMATION DESCRIBED.—The informa- 19 tion described in this paragraph is the following in- 20 formation with respect to covered part D drugs 21 under such part D: 22 ‘‘(A) The information described in sub- 23 paragraphs (A) through (D) of subsection 24 (b)(2). 25 VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1773 IS ‘‘(B) Information on average annual bene- 1 ficiary out-of-pocket costs below and above the 2 annual out-of-pocket threshold under section 3 1860D–2(b)(4)(B) for the current plan year. 4 Such information shall not include out-of-pocket 5 costs for subsidy eligible individuals under sec- 6 tion 1860D–14. 7 ‘‘(C) Information on how to access re- 8 sources as described in sections 1860D–1(c) 9 and 1851(d). 10 ‘‘(D) For the most recent calendar year for 11 which data is available— 12 ‘‘(i) the 15 covered part D drugs with 13 the highest total spending under such part; 14 and 15 ‘‘(ii) any covered part D drug for 16 which the average annual per beneficiary 17 spending exceeds the gross spending for 18 covered part D drugs at which the annual 19 out-of-pocket threshold under section 20 1860D–2(b)(4)(B) would be met for the 21 year. 22 ‘‘(E) Other information (not otherwise pro- 23 hibited in law from being disclosed) that the 24 Secretary determines would provide bene- 25 VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1773 IS ficiaries, clinicians, researchers, and the public 1 with helpful information about covered part D 2 drug spending and utilization (including trends 3 of such spending and utilization). 4 ‘‘(d) MEDICAID COVERED OUTPATIENT DRUG DASH- 5 BOARD.— 6 ‘‘(1) IN GENERAL.—The dashboard established 7 under subsection (a) for title XIX shall provide the 8 information described in paragraph (2). 9 ‘‘(2) INFORMATION DESCRIBED.—The informa- 10 tion described in this paragraph is the following in- 11 formation with respect to covered outpatient drugs 12 under such title: 13 ‘‘(A) The information described in sub- 14 paragraphs (A) through (D) of subsection 15 (b)(2). 16 ‘‘(B) For the most recent calendar year for 17 which data is available, the 15 covered out- 18 patient drugs with the highest total spending 19 under such title. 20 ‘‘(C) Other information (not otherwise pro- 21 hibited in law from being disclosed) that the 22 Secretary determines would provide bene- 23 ficiaries, clinicians, researchers, and the public 24 with helpful information about covered out- 25 VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1773 IS patient drug spending and utilization (including 1 trends of such spending and utilization). 2 ‘‘(e) DATA FILES.—The Secretary shall make avail- 3 able the underlying data for each dashboard established 4 under subsection (a) in a machine-readable format.’’. 5 Æ VerDate Sep 11 2014 05:44 Jun 08, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6301 E:\BILLS\S1773.IS S1773 kjohnson on DSK79L0C42PROD with BILLS