Summary#
This bill changes how certain prescription drugs are paid for by military health plans, veterans, and some federal buyers when those drugs are part of the Drug Price Negotiation Program under the Social Security Act.
For drugs designated as "selected drugs" by that program, the bill says:
- TRICARE cost-sharing for eligible beneficiaries may not be higher than the cost-sharing a Medicare Part D beneficiary pays for that same drug in the same year.
- Veteran copayments for such drugs may not be higher than the copayment a Medicare Part D beneficiary pays for that drug in the same year.
- For federal agencies that buy drugs (through master agreements under title 38), manufacturers may not set a maximum price above the program's "maximum fair price" for the duration of each master agreement while the drug is covered by the negotiation program.
The bill defines "selected drug" by reference to the Social Security Act and says the procurement-price limits apply to master agreements already in effect and to those entered after the bill becomes law. If the Drug Price Negotiation Program ends, affected master agreements must be modified to reflect existing law price limits at that time.
What it means for you#
- If you get health care through TRICARE and the Drug Price Negotiation Program covers a medicine you need, your out-of-pocket cost for that medicine in that year cannot be more than what a Medicare Part D enrollee would pay for that medicine that year.
- If you are a veteran getting medication through the Department of Veterans Affairs, your copayment for a negotiated medicine in that year cannot be more than what a Medicare Part D enrollee pays for the same medicine that year.
- For federal buyers (including the VA), the bill limits the maximum price a manufacturer may list in a master purchasing agreement for a negotiated drug to the program's maximum fair price while the drug is covered.
Expenses#
No publicly available information on budgetary cost estimates or projected savings is included in the bill text. The bill text does not include a Congressional Budget Office estimate or specific dollar amounts for federal costs or savings.
Proponents' View#
No publicly available information.
Opponents' View#
No publicly available information.