I 

116TH CONGRESS 

1ST SESSION H. R. 5239 

To require reporting on prescription drug expenditures under group health 

plans and on prescription drug price changes, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 21, 2019 

Mr. JOYCE of Ohio introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL 

To require reporting on prescription drug expenditures under 

group health plans and on prescription drug price 

changes, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Prescription Drug 

5 Price Reporting Act’’. 

6 SEC. 2. PRESCRIPTION DRUG PRICE REPORTING REQUIRE7 MENTS. 

8 (a) SUBMISSION OF DATA.— 

9 (1) IN GENERAL.—Each manufacturer of a pre10 scription drug shall submit to the Secretary, elecVerDate Sep 11 2014 03:09 Dec 06, 2019 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H5239.IH H5239

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1 tronically, in such manner as the Secretary may re2 quire, by April 1 of each year, a list of each such 

3 drug that is marketed in the United States and, 

4 with respect to each such drug, all of the following 

5 information with respect to the previous year: 

6 (A) Each applicable National Drug Code 

7 (or J–Code). 

8 (B) Brand name. 

9 (C) Generic name and chemical name, as 

10 applicable. 

11 (D) Therapeutic class or classes, as appli12 cable. 

13 (E) Current wholesale acquisition cost per 

14 30-day supply or typical course of treatment. 

15 (F) Average wholesale acquisition cost for 

16 the drug per 30-day supply or typical course of 

17 treatment during the previous calendar year, or, 

18 in the case of a drug that has been marketed 

19 for only a portion of such year, during the por20 tion of time in such year that the drug was 

21 marketed. 

22 (G) Average net price per 30-day supply or 

23 typical course of treatment, during the previous 

24 calendar year, or, in the case of a drug that has 

25 been marketed for only a portion of such year, 


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1 during the portion of time in such year that the 

2 drug was marketed, taking into account all dis3 counts, rebates, and other fees or payments to 

4 health insurance plans or pharmacy benefit 

5 managers with respect to sales of the drug to 

6 individuals covered by such a plan. 

7 (H) Total rebates and other payments to 

8 health insurance plans or pharmacy benefit 

9 managers, per 30-day supply or typical course 

10 of treatment, with respect to individuals covered 

11 by such a plan, during the previous calendar 

12 year, or, in the case of a drug that has been 

13 marketed for only a portion of such calendar 

14 year, during the portion of time in such cal15 endar year that the drug was marketed. 

16 (2) TIMELINE FOR INITIAL SUBMISSION.— 

17 (A) DRUGS MARKETED BEFORE DECEM18 BER 31, 2020.—Each manufacturer of a pre19 scription drug that is marketed at any time 

20 during calendar year 2020, shall submit to the 

21 Secretary, not later than April 1, 2021— 

22 (i) the information required under 

23 paragraph (1); and 

24 (ii) in addition to the information re25 quired under subparagraphs (F), (G), and 


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1 (H) of paragraph (1), such average whole2 sale acquisition cost, average net price, and 

3 total rebates and other payments, de4 scribed in each of such subparagraphs, re5 spectively, with respect to the calendar 

6 year immediately preceding the calendar 

7 year for which such information is required 

8 to be reported under such subparagraphs 

9 (F), (G), and (H). 

10 (B) SUBSEQUENTLY MARKETED DRUGS.— 

11 With respect to a prescription drug that is first 

12 marketed after December 31, 2020, each manu13 facturer of such a drug shall submit the infor14 mation required under subparagraphs (A) 

15 through (E) of paragraph (1) not later than 60 

16 days after the date on which the drug is first 

17 marketed, and shall submit annual reports of 

18 all of the information required under paragraph 

19 (1) beginning on the first annual reporting date 

20 that is more than 30 days after the date on 

21 which the drug is first marketed. 

22 (b) ADVANCE NOTIFICATION OF PRESCRIPTION

23 DRUG PRICING CHANGES.— 

24 (1) IN GENERAL.—Each manufacturer of a pre25 scription drug shall report to the Secretary, elecVerDate Sep 11 2014 03:09 Dec 06, 2019 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H5239.IH H5239

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1 tronically, in such manner as the Secretary may re2 quire, any increase or decrease in the wholesale ac3 quisition cost of a prescription drug not later than 

4 30 days prior to the date on which the price change 

5 takes effect. 

6 (2) CONTENT.—A price change report under 

7 paragraph (1) shall include— 

8 (A) the information required under sub9 paragraphs (A), (B), (C), (D), and (F) of sub10 section (a)(1); 

11 (B) the wholesale acquisition cost per 30- 

12 day supply or typical course of treatment imme13 diately prior to the price change; 

14 (C) the new wholesale acquisition cost per 

15 30-day supply or typical course of treatment, 

16 when the change takes effect; and 

17 (D) financial and non-financial factors the 

18 manufacturer took into consideration when 

19 making the price change, including any changes 

20 or improvements to the drug. 

21 (c) PUBLIC DATABASE.— 

22 (1) IN GENERAL.—The Secretary shall establish 

23 an internet-based system to post prescription drug 

24 information reported under subsection (a) and price 

25 change reports required under subsection (b). 


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1 (2) CONSUMER SUBSCRIPTION OPTIONS.—The 

2 system established under paragraph (1) shall enable 

3 consumers to subscribe to price change notifica4 tions— 

5 (A) for— 

6 (i) all drugs; 

7 (ii) a particular drug; or 

8 (iii) a particular therapeutic class of 

9 drugs; and 

10 (B) that are limited to price changes that 

11 are at or over a specified amount. 

12 (3) TIMING.—The prescription drug informa13 tion reported under subsection (a) shall be made 

14 publicly available not later than 30 days after being 

15 reported to the Secretary. In the case of a price 

16 change report required under subsection (b), the 

17 Secretary shall make publicly available a notice of 

18 the price change contained in such report on the day 

19 such change takes effect. 

20 (d) PRIVACY PROTECTIONS.—The information sub21 mitted under subparagraphs (A) through (F) of subsection 

22 (a)(1) and paragraph (2)(A)(ii) shall be publicly available 

23 through the database established under subsection (c). No 

24 other information submitted to the Secretary pursuant to 

25 subsection (a) or (b) that is proprietary, confidential, or 


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1 trade secret information shall be included in such data2 base. 

3 (e) DEFINITIONS.—For purposes of this section— 

4 (1) the term ‘‘manufacturer’’ has the meaning 

5 given such term in section 581 of the Federal Food, 

6 Drug, and Cosmetic Act (21 U.S.C. 360eee); 

7 (2) the term ‘‘prescription drug’’ means a drug 

8 approved section 505 of the Federal Food, Drug, 

9 and Cosmetic Act (21 U.S.C. 355) or a biological 

10 product licensed under section 351 of the Public 

11 Health Service Act (42 U.S.C. 262) that is subject 

12 to section 503(b)(1) of the Federal Food, Drug, and 

13 Cosmetic Act (21 U.S.C. 353(b)(1)); 

14 (3) the term ‘‘Secretary’’ means the Secretary 

15 of Health and Human Services; and 

16 (4) the term ‘‘wholesale acquisition cost’’ has 

17 the meaning given such term in section 

18 1847A(c)(6)(B) of the Social Security Act (42 

19 U.S.C. 1395w–3a (c)(6)(B)). 

20 (f) PREEMPTION.—Effective on the date that the 

21 public database under subsection (b)(3) first becomes 

22 operational, no State or political subdivision of a State 

23 may establish or continue in effect any law requiring the 


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1 manufacturer to report or make public prescription drug 

2 pricing information. 

Æ 


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