I
106TH CONGRESS
2D SESSION
H. R. 5467
To provide for substantial reductions in the price of prescription drugs for
Medicare beneficiaries and for women diagnosed with breast cancer.
IN THE HOUSE OF REPRESENTATIVES
OCTOBER 12, 2000
Mrs. MCCARTHY of New York introduced the following bill; which was re-
ferred to the Committee on Commerce, and in addition to the Committee
on Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall within
the jurisdiction of the committee concerned
A BILL
To provide for substantial reductions in the price of prescrip-
tion drugs for Medicare beneficiaries and for women
diagnosed with breast cancer.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘Breast Cancer Pre-
scription Drug Fairness Act’’.
SEC. 2. FINDINGS AND PURPOSES.
(a) FINDINGS.—The Congress finds the following:
(1) All women are at risk for breast cancer and
that risk increases with age.
(2) Breast cancer is the most common cancer
among women.
(3) Annually, there are 180,200 new cases of
breast cancer in the United States, and 2,000 on
Long Island, New York, alone.
(4) Manufacturers of prescription drugs engage
in price discrimination practices that compel many
older Americans and women to pay substantially
more for prescription drugs than the drug manufac-
turers’ most favored customers, such as health in-
surers, health maintenance organizations, and the
Federal Government.
(5) On average, older Americans and women
who buy their own prescription drugs pay twice as
much for prescription drugs as the drug manufac-
turers’ most favored customers. In some cases, older
Americans and women pay over 15 times more for
prescription drugs than the most favored customers.
(6) The discriminatory pricing by major drug
manufacturers sustains their annual profits of
$20,000,000,000, but causes financial hardship and
impairs the health and well-being of millions of older
Americans and women. More than one in eight older
Americans and women are forced to choose between
buying their food and buying their medicines.
(7) Most federally funded health care programs,
including Medicaid, the Veterans Health Administra-
tion, the Public Health Service, and the Indian
Health Service, obtain prescription drugs for their
beneficiaries at low prices. Medicare beneficiaries are
denied this benefit and cannot obtain their prescrip-
tion drugs at the favorable prices available to other
federally funded health care programs.
(8) Implementation of the policy set forth in
this Act is estimated to reduce prescription drug
prices for Medicare beneficiaries by more than 40
percent.
(9) In addition to substantially lowering the
costs of prescription drugs for older Americans and
women, implementation of the policy set forth in this
Act will significantly improve the health and well-
being of older Americans and women and lower the
costs to the Federal taxpayer of the Medicare pro-
gram.
(10) Older Americans and women who are ter-
minally ill and receiving hospice care services rep-
resent some of the most vulnerable individuals in our
nation. Making prescription drugs available to Medi-
care beneficiaries under the care of Medicare-cer-
tified hospices will assist in extending the benefits of
lower prescription drug prices to those most vulner-
able and in need.
(b) PURPOSE.—The purpose of this Act is to protect
women diagnosed with breast cancer and Medicare bene-
ficiaries from discriminatory pricing by drug manufactur-
ers and to make prescription drugs available to Medicare
beneficiaries at substantially reduced prices.
SEC. 3. PARTICIPATING MANUFACTURERS.
(a) IN GENERAL.—Each participating manufacturer
of a covered outpatient drug shall make available for pur-
chase by each pharmacy such covered outpatient drug in
the amount described in subsection (b) at the price de-
scribed in subsection (c).
(b) DESCRIPTION
OF AMOUNT
OF DRUGS.—The
amount of a covered outpatient drug that a participating
manufacturer shall make available for purchase by a phar-
macy is an amount equal to the aggregate amount of the
covered outpatient drug sold or distributed by the phar-
macy to Medicare beneficiaries.
(c) DESCRIPTION OF PRICE.—The price at which a
participating manufacturer shall make a covered out-
patient drug available for purchase by a pharmacy is the
price equal to the lower of the following:
(1) The lowest price paid for the covered out-
patient drug by any agency or department of the
United States.
(2) The manufacturer’s best price for the cov-
ered 
outpatient 
drug, 
as 
defined 
in 
section
1927(c)(1)(C) of the Social Security Act (42 U.S.C.
1396r–8(c)(1)(C)).
SEC. 4. SPECIAL PROVISION WITH RESPECT TO HOSPICE
PROGRAMS.
For purposes of determining the amount of a covered
outpatient drug that a participating manufacturer shall
make available for purchase by a pharmacy under section
3, there shall be included in the calculation of such
amount the amount of the covered outpatient drug sold
or distributed by a pharmacy to a hospice program. In
calculating such amount, only amounts of the covered out-
patient drug furnished to a Medicare beneficiary enrolled
in the hospice program shall be included.
SEC. 5. ADMINISTRATION.
The Secretary shall issue such regulations as may be
necessary to implement this Act.
SEC. 6. REPORTS TO CONGRESS REGARDING EFFECTIVE-
NESS OF ACT.
(a) IN GENERAL.—Not later than 2 years after the
date of the enactment of this Act, and annually thereafter,
the Secretary shall report to the Congress regarding the
effectiveness of this Act in—
(1) protecting Medicare beneficiaries from dis-
criminatory pricing by drug manufacturers, and
(2) making prescription drugs available to
Medicare beneficiaries at substantially reduced
prices.
(b) CONSULTATION.—In preparing such reports, the
Secretary shall consult with public health experts, affected
industries, organizations representing consumers and
older Americans and women, and other interested persons.
(c) RECOMMENDATIONS.—The Secretary shall in-
clude in such reports any recommendations they consider
appropriate for changes in this Act to further reduce the
cost of covered outpatient drugs to Medicare beneficiaries.
SEC. 7. DEFINITIONS.
In this Act:
(1) 
PARTICIPATING
MANUFACTURER.—The
term ‘‘participating manufacturer’’ means any man-
ufacturer of drugs or biologicals that, on or after the
date of the enactment of this Act, enters into a con-
tract or agreement with the United States for the
sale or distribution of covered outpatient drugs to
the United States.
SEC. 9. STUDY ON LIFE EXPECTANCY OF WOMEN DIAG-
NOSED WITH BREAST CANCER WHO LACK
PRESCRIPTION DRUG COVERAGE.
(a) STUDY.—The Secretary of Health and Human
Services, acting through the Director of the Center for
Disease Control and Prevention, shall conduct a study on
women diagnosed with breast cancer and analyze the ef-
fect, if any, that the lack of prescription drug coverage
has on the life expectancy of such women.
(b) REPORT.—By not later than one year after the
date of the enactment of this Act, the Secretary shall sub-
mit to Congress a report on the study conducted under
subsection (a).
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