Prescription Drug Pricing Dashboard Act

To amend title XI of the Social Security Act to establish internet website-based dashboards to allow the public to review information on spending for, and utilization of, prescription drugs and biologicals covered under the Medicare and Medicaid programs. 1. Short title This Act may be cited as the Prescription Drug Pricing Dashboard Act 2. Prescription drug pricing dashboards Part A of title XI of the Social Security Act is amended by adding at the end the following new section: 1150D. Prescription drug pricing dashboards (a) In general Beginning not later than January 1, 2022, the Secretary shall establish, and annually update, internet website-based dashboards, through which beneficiaries, clinicians, researchers, and the public can review information on spending for, and utilization of, prescription drugs and biologicals (and related supplies and mechanisms of delivery) covered under each of parts B and D of title XVIII and under a State program under title XIX, including information on trends of such spending and utilization over time. (b) Medicare part B drug and biological dashboard (1) In general The dashboard established under subsection (a) for part B of title XVIII shall provide the information described in paragraph (2). (2) Information described The information described in this paragraph is the following information with respect to drug or biologicals covered under such part B: (A) The brand name and, if applicable, the generic names of the drug or biological. (B) Consumer-friendly information on the uses and clinical indications of the drug or biological. (C) The manufacturer or labeler of the drug or biological. (D) To the extent feasible, the following information: (i) Average total spending per dosage unit of the drug or biological in the most recent 2 calendar years for which data is available. (ii) The percentage change in average spending on the drug or biological per dosage unit between the most recent calendar year for which data is available and— (I) the preceding calendar year; and (II) the preceding 5 and 10 calendar years. (iii) The annual growth rate in average spending per dosage unit of the drug or biological in the most recent 5 or 10 calendar years for which data is available. (iv) Total spending for the drug or biological for the most recent calendar year for which data is available. (v) The number of beneficiaries receiving the drug or biological in the most recent calendar year for which data is available. (vi) Average spending on the drug per beneficiary for the most recent calendar year for which data is available. (E) The average sales price of the drug or biological (as determined under section 1847A) for the most recent quarter. (F) Consumer-friendly information about the coinsurance amount for the drug or biological for beneficiaries for the most recent quarter. Such information shall not include coinsurance amounts for qualified medicare beneficiaries (as defined in section 1905(p)(1)). (G) For the most recent calendar year for which data is available— (i) the 15 drugs and biologicals with the highest total spending under such part; and (ii) any drug or biological for which the average annual per beneficiary spending exceeds the gross spending for covered part D drugs at which the annual out-of-pocket threshold under section 1860D–2(b)(4)(B) would be met for the year. (H) Other information (not otherwise prohibited in law from being disclosed) that the Secretary determines would provide beneficiaries, clinicians, researchers, and the public with helpful information about drug and biological spending and utilization (including trends of such spending and utilization). (c) Medicare covered part D drug dashboard (1) In general The dashboard established under subsection (a) for part D of title XVIII shall provide the information described in paragraph (2). (2) Information described The information described in this paragraph is the following information with respect to covered part D drugs under such part D: (A) The information described in subparagraphs (A) through (D) of subsection (b)(2). (B) Information on average annual beneficiary out-of-pocket costs below and above the annual out-of-pocket threshold under section 1860D–2(b)(4)(B) for the current plan year. Such information shall not include out-of-pocket costs for subsidy eligible individuals under section 1860D–14. (C) Information on how to access resources as described in sections 1860D–1(c) and 1851(d). (D) For the most recent calendar year for which data is available— (i) the 15 covered part D drugs with the highest total spending under such part; and (ii) any covered part D drug for which the average annual per beneficiary spending exceeds the gross spending for covered part D drugs at which the annual out-of-pocket threshold under section 1860D–2(b)(4)(B) would be met for the year. (E) Other information (not otherwise prohibited in law from being disclosed) that the Secretary determines would provide beneficiaries, clinicians, researchers, and the public with helpful information about covered part D drug spending and utilization (including trends of such spending and utilization). (d) Medicaid covered outpatient drug dashboard (1) In general The dashboard established under subsection (a) for title XIX shall provide the information described in paragraph (2). (2) Information described The information described in this paragraph is the following information with respect to covered outpatient drugs under such title: (A) The information described in subparagraphs (A) through (D) of subsection (b)(2). (B) For the most recent calendar year for which data is available, the 15 covered outpatient drugs with the highest total spending under such title. (C) Other information (not otherwise prohibited in law from being disclosed) that the Secretary determines would provide beneficiaries, clinicians, researchers, and the public with helpful information about covered outpatient drug spending and utilization (including trends of such spending and utilization). (e) Data files The Secretary shall make available the underlying data for each dashboard established under subsection (a) in a machine-readable format. .

Summary: Prescription Drug Pricing Dashboard Act This bill provides statutory authority for, and establishes requirements regarding, the Medicare and Medicaid prescription drug pricing dashboards that are operated by the Centers for Medicare & Medicaid Services (CMS). The dashboards provide spending information for covered drugs, including the average spending per dosage unit and changes in spending over time. The bill requires the CMS to update the dashboards annually and to include specified information, such as information about out-of-pocket costs and the drugs that have the highest total spending under each program.