S.Amdt. 5802

SA 5802. Mr. SANDERS submitted an amendment intended to be proposed
by him to the bill S. 2, to provide for reconciliation pursuant to
title II of S. Con. Res. 33.; which was ordered to lie on the table; as
follows:

At the appropriate place, insert the following:

SEC. __. IMPROVEMENTS TO THE MEDICARE DRUG PRICE NEGOTIATION
PROGRAM.

(a) Acceleration of the Selection of Negotiation-Eligible
Drugs.--Section 1192(a) of the Social Security Act (42 U.S.C.
1320f-1(a)) is amended--
(1) in paragraph (2), by adding ``and'' at the end;
(2) in paragraph (3)--
(A) by striking ``2028, 15 negotiation-eligible drugs'' and
inserting ``2028 or a subsequent initial price applicability
year, at least 50 negotiation-eligible drugs'';
(B) by striking ``less than 15'' and inserting ``less than
50''; and
(C) by striking ``; and'' at the end and inserting a
period; and
(3) by striking paragraph (4).
(b) Improvements to the Definition of Negotiation-Eligible
Drugs.--Subparagraphs (A) and (B) of section 1192(d)(1) of
the Social Security Act (42 U.S.C. 1320f-1(d)(1)) are each
amended by striking ``among the 50'' and inserting ``among
the 50 (or, in the case of initial price applicability year
2028 or a subsequent initial price applicability year,
125)''.
(c) Improvements to the Definition of Qualifying Single
Source Drugs.--Subparagraphs (A)(ii) and (B)(ii) of section

[[Page S2639]]

1192(e)(1) of the Social Security Act (42 U.S.C. 1320f-
1(e)(1)) are each amended by striking ``for which'' and
inserting ``with respect to initial price applicability year
2026 and 2027, for which''.
(d) Improvement to the Ceiling for Maximum Fair Price.--
Section 1194(c)(1) of the Social Security Act (42 U.S.C.
1320f-3(c)(1)) is amended--
(1) in subparagraph (A), by striking ``or the amount under
subparagraph (C)'' and inserting ``, the amount under
subparagraph (C), or, if available, the amount under
subparagraph (D)''; and
(2) by adding at the end the following new subparagraph:
``(D) Subparagraph (D) amount.--
``(i) In general.--An amount equal to the international
maximum fair price for the drug or biological product.
``(ii) International maximum fair price.--For purposes of
clause (i), the term `international maximum fair price'
means, with respect to a drug or biological product, an
amount equal to the highest price (which shall be the net
price, if practicable, and volume-weighted, if practicable)
for a unit (as defined in section 1191(c)(6)) of such drug or
biological product for sales of such drug or biological
product (calculated across different dosage forms and
strengths of the drug or biological product and not based on
the specific formulation or package size or package type), as
computed (as of the date of publication of such drug or
biological product as a selected drug) among any applicable
countries for which pricing information is available with
respect to such drug or biological product.
``(iii) Applicable countries.--

``(I) In general.--For purposes of clause (ii), the term
`applicable countries' includes any country described in
subclause (II) for which, with respect to a drug or
biological product, there is available a price for any unit
of such drug or biological product for sales of such drug or
biological product in such country.
``(II) Countries described.--For purposes of subclause (I),
the following countries are described in this subclause:

``(aa) Australia.
``(bb) Canada.
``(cc) France.
``(dd) Germany.
``(ee) Japan.
``(ff) The United Kingdom.''.
(e) Effective Date.--The amendments made by this section
shall apply with respect to initial price applicability years
(as defined in section 1191(b) of the Social Security Act (42
U.S.C. 1320f(b)) beginning with initial price applicability
year 2028.
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