thority for which is not provided for in advance in 
appropriations Acts, for the purchase and delivery of 
opioid overdose reversal drug products under sub-
section (a). 
‘‘(2) AUTHORITY
TO
DECLINE
CONTRACTS.— 
The Secretary may decline to enter into contracts 
under this subsection and may modify or extend 
such contracts. 
‘‘(3) CONTRACT PRICE.— 
‘‘(A) IN GENERAL.—The Secretary, in ne-
gotiating the prices at which opioid overdose re-
versal drug products will be purchased and de-
livered from a manufacturer under this sub-
section, shall take into account quantities of 
opioid overdose reversal drug products to be 
purchased by States under the option under 
paragraph (4)(B). 
‘‘(B) NEGOTIATION OF DISCOUNTED PRICE 
FOR OPIOID OVERDOSE REVERSAL DRUG PROD-
UCTS.—With respect to contracts entered into 
for the purchase of opioid overdose reversal 
drug products on behalf of States under this 
subsection, the price for the purchase of such 
drug product shall be a discounted price nego-
tiated by the Secretary. 
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‘‘(4) PRODUCT
DOSAGE.—All opioid overdose 
reversal products purchased under this section shall 
contain— 
‘‘(A) for each dose, the maximum amount 
of active pharmaceutical ingredient that acts as 
an opioid receptor antagonist as recommended 
by the Food and Drug Administration as an 
initial dose when administered by one of the ap-
proved, labeled routes of administration in 
adults; and 
‘‘(B) a minimum of two doses packaged to-
gether. 
‘‘(5) QUANTITIES AND TERMS OF DELIVERY.— 
Under contracts under this subsection— 
‘‘(A) the Secretary shall provide, consistent 
with paragraph (6), for the purchase and deliv-
ery on behalf of States and Indian tribes of 
quantities of opioid overdose reversal drug 
products; and 
‘‘(B) each State and Indian tribe, at the 
option of the State or tribe, shall be permitted 
to obtain additional quantities of opioid over-
dose reversal drug products (subject to amounts 
specified to the Secretary by the State or tribe 
in advance of negotiations) through purchasing 
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the opioid overdose reversal drug products from 
the manufacturers at the applicable price nego-
tiated by the Secretary consistent with para-
graph (3), if the State or tribe provides to the 
Secretary such information (at a time and man-
ner specified by the Secretary, including in ad-
vance of negotiations under paragraph (1)) as 
the Secretary determines to be necessary, to 
provide for quantities of opioid overdose rever-
sal drug products for the State or tribe to pur-
chase pursuant to this subsection and to deter-
mine annually the percentage of the opioid over-
dose reversal drug market that is purchased 
pursuant to this section and this subparagraph. 
The Secretary shall enter into the initial negotia-
tions not later than 180 days after the date of the 
enactment of this title. 
‘‘(6) CHARGES
FOR
SHIPPING
AND
HAN-
DLING.—The Secretary may enter into a contract 
referred to in paragraph (1) only if the manufac-
turer involved agrees to submit to the Secretary 
such reports as the Secretary determines to be ap-
propriate to assure compliance with the contract and 
if, with respect to a State program under this sec-
tion that does not provide for the direct delivery of 
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100 
qualified opioid overdose reversal drug products, the 
manufacturer involved agrees that the manufacturer 
will provide for the delivery of the opioid overdose 
reversal drug products on behalf of the State in ac-
cordance with such program and will not impose any 
charges for the costs of such delivery (except to the 
extent such costs are provided for in the price estab-
lished under paragraph (3)). 
‘‘(7) MULTIPLE SUPPLIERS.—In the case of the 
opioid overdose reversal drug product involved, the 
Secretary may, as appropriate, enter into a contract 
referred to in paragraph (1) with each manufacturer 
of the opioid overdose reversal drug product that 
meets the terms and conditions of the Secretary for 
an award of such a contract (including terms and 
conditions regarding safety and quality). With re-
spect to multiple contracts entered into pursuant to 
this paragraph, the Secretary may have in effect dif-
ferent prices under each of such contracts and, with 
respect to a purchase by States pursuant to para-
graph (4)(B), each eligible State may choose which 
of such contracts will be applicable to the purchase. 
‘‘(c) USE OF OPIOID OVERDOSE REVERSAL DRUG 
PRODUCT LIST.—Beginning not later than one year after 
the first contract has been entered into under this section, 
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101 
the Secretary shall use, for the purpose of the purchase, 
delivery, and administration of opioid overdose reversal 
drug products under this section, the list established (and 
periodically reviewed and, as appropriate, revised) by an 
advisory committee, established by the Secretary and lo-
cated within the Centers for Disease Control and Preven-
tion, which considers the cost effectiveness of each opioid 
overdose reversal drug product. 
‘‘(d) STATE DISTRIBUTION OF OPIOID OVERDOSE 
REVERSAL DRUG PRODUCTS.—States shall distribute 
opioid overdose reversal drug products received under this 
section to the following: 
‘‘(1) First Responders, including— 
‘‘(A) all State, county, and local law en-
forcement departments; 
‘‘(B) all Tribal police departments; 
‘‘(C) all local fire departments, including 
career fire departments, combination fire de-
partments, and volunteer fire departments; and 
‘‘(D) all local emergency medical services 
organizations, including volunteer emergency 
medical services organizations. 
‘‘(2) Public entities with authority to administer 
local public health services, including all local health 
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102 
departments, for the purposes of making opioid over-
dose reversal drug products available to— 
‘‘(A) public and nonprofit entities, includ-
ing— 
‘‘(i) community-based organizations 
that provide substance use disorder treat-
ments or harm reduction services; 
‘‘(ii) nonprofit entities that provide 
substance use disorder treatments or harm 
reduction services; and 
‘‘(iii) faith based organizations that 
provide substance use disorder treatments 
or harm reduction services; and 
‘‘(B) the general public. 
‘‘(e) STATE REQUIREMENTS.—To be eligible to re-
ceive opioid overdose reversal drugs under this section, 
each State shall— 
‘‘(1) establish a program for distributing opioid 
overdose reversal drug products to first responders 
and entities with authority to administer local public 
health services, including local health departments; 
‘‘(2) beginning in the second year of the pro-
gram, demonstrate a distribution rate of a minimum 
of 90 percent of the opioid overdose reversal drug 
products received under this program; and 
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