I 
108TH CONGRESS 
1ST SESSION 
H. R. 896
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 
FEBRUARY 25, 2003
Mrs. MCCARTHY of New York introduced the following bill; which was re-
ferred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined 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 of 2003’’. 
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
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.
(2) COVERED OUTPATIENT DRUG.—The term 
‘‘covered outpatient drug’’ has the meaning given 
that term in section 1927(k)(2) of the Social Secu-
rity Act (42 U.S.C. 1396r–8(k)(2)). 
(3) 
MEDICARE
BENEFICIARY.—The 
term 
‘‘Medicare beneficiary’’ means an individual entitled 
to benefits under part A of title XVIII of the Social 
Security Act or enrolled under part B of such title, 
or both, and includes individuals who are not so en-
titled or enrolled but who have been diagnosed with 
breast cancer. 
(4) HOSPICE
PROGRAM.—The term ‘‘hospice 
program’’ has the meaning given that term under 
section 1861(dd)(2) of the Social Security Act (42 
U.S.C. 1395x(dd)(2)). 
(5) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
SEC. 8. EFFECTIVE DATE. 
The Secretary shall implement this Act as expedi-
tiously as practicable and in a manner consistent with the 
obligations of 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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