II 

Calendar No. 19 

118TH CONGRESS 

1ST SESSION S. 113 

To require the Federal Trade Commission to study the role of intermediaries 

in the pharmaceutical supply chain and provide Congress with appropriate policy recommendations, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 26, 2023 

Mr. GRASSLEY (for himself, Ms. CANTWELL, Mr. BLUMENTHAL, Mr. 

LANKFORD, Mrs. BLACKBURN, Mr. TUBERVILLE, Mr. TILLIS, Mrs. CAPITO, Mr. BRAUN, Mr. BOOZMAN, Mr. WELCH, Mr. COONS, Ms. HIRONO, 

and Mrs. FEINSTEIN) introduced the following bill; which was read twice 

and referred to the Committee on the Judiciary 

MARCH 1, 2023 

Reported by Mr. DURBIN, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

A BILL 

To require the Federal Trade Commission to study the role 

of intermediaries in the pharmaceutical supply chain and 

provide Congress with appropriate policy recommendations, 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, 


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•S 113 RS

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Prescription Pricing 

3 for the People Act of 2023’’. 

4 SEC. 2. DEFINITIONS. 

5 In this Act: 

6 (1) APPROPRIATE COMMITTEES OF CON7 GRESS.—The term ‘‘appropriate committees of Con8 gress’’ means— 

9 (A) the Committee on the Judiciary of the 

10 Senate; and 

11 (B) the Committee on the Judiciary of the 

12 House of Representatives. 

13 (2) COMMISSION.—The term ‘‘Commission’’ 

14 means the Federal Trade Commission. 

15 SEC. 3. STUDY OF PHARMACEUTICAL SUPPLY CHAIN 

16 INTERMEDIARIES AND MERGER ACTIVITY. 

17 (a) REPORT.—Not later than 1 year after the date 

18 of enactment of this Act, the Commission shall submit to 

19 the appropriate committees of Congress a report that— 

20 (1) addresses at minimum— 

21 (A) whether pharmacy benefit managers— 

22 (i) charge payers a higher price than 

23 the reimbursement rate at which the phar24 macy benefit managers reimburse phar25 macies owned by the pharmacy benefit 


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•S 113 RS

1 manager and pharmacies not owned by the 

2 pharmacy benefit manager; 

3 (ii) steer patients for competitive ad4 vantage to any pharmacy, including a re5 tail, mail-order, or any other type of phar6 macy, in which the pharmacy benefit man7 agers have an ownership interest; 

8 (iii) audit or review proprietary data, 

9 including acquisition costs, patient infor10 mation, or dispensing information, of phar11 macies not owned by the pharmacy benefit 

12 manager and use such proprietary data to 

13 increase revenue or market share for com14 petitive advantage; or 

15 (iv) use formulary designs to increase 

16 the market share of higher cost prescrip17 tion drugs or depress the market share of 

18 lower cost prescription drugs (each net of 

19 rebates and discounts); 

20 (B) trends or observations on the state of 

21 competition in the healthcare supply chain, par22 ticularly with regard to intermediaries and their 

23 integration with other intermediaries, suppliers, 

24 or payers of prescription drug benefits; 


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1 (C) how companies and payers assess the 

2 benefits, costs, and risks of contracting with 

3 intermediaries, including pharmacy services ad4 ministrative organizations, and whether more 

5 information about the roles of intermediaries 

6 should be available to consumers and payers; 

7 and 

8 (D) whether there are any specific legal or 

9 regulatory obstacles the Commission currently 

10 faces in enforcing the antitrust and consumer 

11 protection laws in the pharmaceutical supply 

12 chain, including the pharmacy benefit manager 

13 marketplace and pharmacy services administra14 tive organizations; and 

15 (2) provides— 

16 (A) observations or conclusions drawn 

17 from the November 2017 roundtable entitled 

18 ‘‘Understanding Competition in Prescription 

19 Drug Markets: Entry and Supply Chain Dy20 namics’’ and any similar efforts; 

21 (B) specific actions the Commission in22 tends to take as a result of the November 2017 

23 roundtable, and any similar efforts, including a 

24 detailed description of relevant forthcoming ac25 tions, additional research or roundtable discusVerDate Sep 11 2014 22:57 Mar 01, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6401 E:\BILLS\S113.RS S113

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•S 113 RS

1 sions, consumer education efforts, or enforce2 ment actions; and 

3 (C) policy or legislative recommendations 

4 to— 

5 (i) improve transparency and competi6 tion in the pharmaceutical supply chain; 

7 (ii) prevent and deter anticompetitive 

8 behavior in the pharmaceutical supply 

9 chain; and 

10 (iii) best ensure that consumers ben11 efit from any cost savings or efficiencies 

12 that may result from mergers and consoli13 dations. 

14 (b) INTERIM REPORT.—Not later than 180 days 

15 after the date of enactment of this Act, the Commission 

16 shall submit to the appropriate committees of Congress 

17 an interim report on the progress of the report required 

18 by subsection (a), along with preliminary findings and 

19 conclusions based on information collected to that date. 

20 SEC. 4. REPORT. 

21 The Commission shall submit to the appropriate com22 mittees of Congress a report that includes— 

23 (1) the number and nature of complaints re24 ceived by the Commission relating to an allegation 


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1 of anticompetitive conduct by a manufacturer of a 

2 sole-source drug; 

3 (2) the ability of the Commission to bring an 

4 enforcement action against a manufacturer of a sole5 source drug; and 

6 (3) policy or legislative recommendations to 

7 strengthen enforcement actions relating to anti8 competitive behavior. 

9 SECTION 1. SHORT TITLE. 

10 This Act may be cited as the ‘‘Prescription Pricing 

11 for the People Act of 2023’’. 

12 SEC. 2. DEFINITIONS. 

13 In this Act: 

14 (1) APPROPRIATE COMMITTEES OF CONGRESS.— 

15 The term ‘‘appropriate committees of Congress’’ 

16 means— 

17 (A) the Committee on the Judiciary of the 

18 Senate; and 

19 (B) the Committee on the Judiciary of the 

20 House of Representatives. 

21 (2) COMMISSION.—The term ‘‘Commission’’ 

22 means the Federal Trade Commission. 


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•S 113 RS

1 SEC. 3. STUDY OF PHARMACEUTICAL SUPPLY CHAIN INTER2 MEDIARIES AND MERGER ACTIVITY. 

3 (a) REPORT.—Not later than 1 year after the date of 

4 enactment of this Act, the Commission shall submit to the 

5 appropriate committees of Congress a report that— 

6 (1) addresses at minimum— 

7 (A) whether pharmacy benefit managers— 

8 (i) charge payers a higher price than 

9 the reimbursement rate at which the phar10 macy benefit managers reimburse phar11 macies owned by the pharmacy benefit 

12 manager and pharmacies not owned by the 

13 pharmacy benefit manager; 

14 (ii) steer patients for competitive ad15 vantage to any pharmacy, including a re16 tail, mail-order, or any other type of phar17 macy, in which the pharmacy benefit man18 agers have an ownership interest; 

19 (iii) audit or review proprietary data, 

20 including acquisition costs, patient infor21 mation, or dispensing information, of phar22 macies not owned by the pharmacy benefit 

23 manager and use such proprietary data to 

24 increase revenue or market share for com25 petitive advantage; or 


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1 (iv) use formulary designs to increase 

2 the market share of higher cost prescription 

3 drugs or depress the market share of lower 

4 cost prescription drugs (each net of rebates 

5 and discounts); 

6 (B) trends or observations on the state of 

7 competition in the healthcare supply chain, par8 ticularly with regard to intermediaries and their 

9 integration with other intermediaries, suppliers, 

10 or payers of prescription drug benefits; 

11 (C) how companies and payers assess the 

12 benefits, costs, and risks of contracting with 

13 intermediaries, including pharmacy services ad14 ministrative organizations, and whether more 

15 information about the roles of intermediaries 

16 should be available to consumers and payers; 

17 (D) whether there are any specific legal or 

18 regulatory obstacles the Commission currently 

19 faces in enforcing the antitrust and consumer 

20 protection laws in the pharmaceutical supply 

21 chain, including the pharmacy benefit manager 

22 marketplace and pharmacy services administra23 tive organizations; and 


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•S 113 RS

1 (E) whether there are any specific legal or 

2 regulatory obstacles that contribute to the cost of 

3 prescription drug prices; and 

4 (2) provides— 

5 (A) observations or conclusions drawn from 

6 the November 2017 roundtable entitled ‘‘Under7 standing Competition in Prescription Drug Mar8 kets: Entry and Supply Chain Dynamics’’ and 

9 any similar efforts; 

10 (B) specific actions the Commission intends 

11 to take as a result of the November 2017 round12 table, and any similar efforts, including a de13 tailed description of relevant forthcoming ac14 tions, additional research or roundtable discus15 sions, consumer education efforts, or enforcement 

16 actions; and 

17 (C) policy or legislative recommendations 

18 to— 

19 (i) improve transparency and competi20 tion in the pharmaceutical supply chain; 

21 (ii) prevent and deter anticompetitive 

22 behavior in the pharmaceutical supply 

23 chain; and 

24 (iii) best ensure that consumers benefit 

25 from any cost savings or efficiencies that 


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•S 113 RS

1 may result from mergers and consolida2 tions. 

3 (b) INTERIM REPORT.—Not later than 180 days after 

4 the date of enactment of this Act, the Commission shall sub5 mit to the appropriate committees of Congress an interim 

6 report on the progress of the report required by subsection 

7 (a), along with preliminary findings and conclusions based 

8 on information collected to that date. 

9 SEC. 4. REPORT. 

10 The Commission shall submit to the appropriate com11 mittees of Congress a report that includes— 

12 (1) the number and nature of complaints re13 ceived by the Commission relating to an allegation of 

14 anticompetitive conduct by a manufacturer of a sole15 source drug; 

16 (2) the ability of the Commission to bring an en17 forcement action against a manufacturer of a sole18 source drug; and 

19 (3) policy or legislative recommendations to 

20 strengthen enforcement actions relating to anti21 competitive behavior. 


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Calendar No. 19 

118TH CONGRESS 

1ST SESSION S. 113 

A BILL 

To require the Federal Trade Commission to study 

purposes. priate policy recommendations, and for other supply chain and provide Congress with approthe role of intermediaries in the pharmaceutical 

MARCH 1, 2023 

Reported with an amendment 


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