On July 23, 2019, the Chairman and Ranking Member of the Senate Finance Committee, Sens. Chuck Grassley [R-GA] and Ron Wyden [D-OR], introduced the Prescription Drug Pricing Reduction Act (PDPRA) of 2019. This bipartisan legislation, if passed, would take several steps to reduce the cost of prescription drugs in the U.S. This bill is scheduled to be marked up by the Senate Finance Committee on Thursday, July 25, 2019. Some provisions of the legislation that could put pressure on drug makers to lower medication prices and could result in cost-savings for Medicare beneficiaries, including:
• Requiring Part D plans to provide a real-time benefit tool that enables electronic transmission of formulary and benefit information to an enrollee’s clinician;
• Requiring pharmaceutical manufacturers that participate in Medicare Part B and Part D to pay rebates to the federal government if the prices of their products rise faster than inflation;
• Allows a Part D insurer to request Part A and Part B claims data from HHS to better coordinate care and reduce adverse events;
• Requiring the Department of Health and Human Services to publish data online regarding aggregate price concessions, the aggregate difference between what an insurer pays a pharmacy benefit manager and what a pharmacy benefit manager pays pharmacies, and the aggregate number of prescriptions dispensed; and
• Requiring pharmaceutical manufacturers to provide the government and the public with justification reports if their prices rise beyond a certain threshold.