An Act To Reduce Prescription Drug Costs by Using International Pricing
Maine Legislature, Session 130, LD 1636
Committee Amendment CA_A_S488 (Senate)

COMMITTEE AMENDMENT "fr "to S.P. 520, L.D. 1636, "An Act To Reduce 
Prescription Drug Costs by Using International Pricing" 
Amend the bill by striking out the title and substituting the following: 
'An Act To Determine Potential Savings in Prescription Drug Costs by Using 
International Pricing' 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 22 MRSA c. 1683, sub-c. 4 is enacted to read: 
SUBCHAPTER 4 
INTERNATIONAL REFERENCED RATE PRICING FOR PRESCRIPTION 
DRUGS 
§8741. International referenced rate pricing 
1. Definitions. As used in this section, unless the context otherwise indicates, the 
following terms have the following meanings. 
A. "Manufacturer" has the same meaning as in section 8731, subsection 3. 
B. "Prescription drug" has the same meaning as in section 8731, subsection 3-A. 
C. 
"Referenced rate" means the maximum rate established using the wholesale 
acquisition cost and other pricing data described in subsection 2, paragraph B. 
D. "Wholesale acquisition cost" has the same meaning as in section 8731, subsection 
§.,_ 
2. Referenced rates determined. The following provisions govern the determination 
of referenced rates of prescription drugs. 
COMMITTEE AMENDMENT 
~o'q 
COMMITTEE AMENDMENT" ,4"to S.P. 520,L.D.1636 (~-Y w) 
A. 
Based on the payments reported in the organization's claims database, the 
organization shall identify the 100 most costly prescription drugs and the 100 most 
frequently prescribed prescription drugs in the State, the manufacturers of those drugs 
and the average wholesale acquisition cost for each drug for the most current 12-month 
period. 
B. To the extent possible, the organization, in conjunction with the Maine Prescription 
Drug Affordability Board established in Title 5, section 12004-G, subsection 14-1, shall 
determine the referenced rate for each drug identified in paragraph A by comparing the 
wholesale acquisition cost to the cost in official publications of the governments of the 
Canadian provinces of Ontario, Quebec, British Columbia and Alberta. The referenced 
rate for each prescription drug must be calculated as the lowest cost among the 
resources described in this paragraph and the wholesale acquisition cost for the most 
recent 12-month period. If a specific drug identified in paragraph A is not included 
within the resources described in this paragraph, the organization shall use for the 
purpose of determining the referenced rate the ceiling price for drugs as reported in 
other official publications of the government of Canada. 
C. For each drug identified in paragraph A, the organization shall determine the 
potential savings that could be achieved by subjecting those drugs to the referenced 
rate as calculated pursuant to paragraph B. The savings must be determined based on 
the payments reported in the organization's claims database for the most current 12-
month period. 
3. Reporting. By January 1, 2023, and annually thereafter, the organization shall 
produce and post on its publicly accessible website a report including the information 
required under subsection 2. The organization shall submit the report required by this 
subsection to the Office of Affordable Health Care established in Title 5, section 3122, the 
Maine Prescription Drug Affordability Board established in Title 5, section 12004-G, 
subsection 14-1 and the joint standing committee of the Legislature having jurisdiction over 
health data reporting and prescription drug matters. The joint standing committee of the 
Legislature having jurisdiction over health data reporting and prescription drug matters 
may report out legislation based on the report to the first regular or second regular session 
of the Legislature, depending on the year in which the report is submitted.' 
Amend the bill by relettering or renumbering any nonconsecutive Part letter or section 
number to read consecutively. 
SUMMARY 
This amendment replaces the bill. Beginning January 1, 2023, the amendment requires 
the Maine Health Data Organization to annually report on the 100 most costly prescription 
drugs and the 100 most frequently prescribed prescription drugs in the State determined 
based on the payments reported in the organization's claims database for the most current 
12-month period and determine the potential savings that could be achieved by subjecting 
those drugs to a referenced rate. The referenced rate must be calculated as the lowest cost 
from official publications of certain Canadian provincial government agencies and the 
wholesale acquisition cost. 
FISCAL NOTE REQUIRED 
(See attached) 
COMMITTEE AMENDMENT 
Approved: 03/29/22 feae 
LD 1636 
LR 1575(02) 
An Act To Reduce Prescription Drug Costs by Using International Pricing 
Fiscal Note for Bill as Amended by Committee Amendment ''fP { S· Y. ~ 
Committee: Health Coverage, Insurance and Financial Services 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - Other Speical Revenue Funds 
Fiscal Detail and Notes 
Any additional costs to the Maine Health Data Organization are expected to be minor and can be absorbed within 
existing budgeted resources. 
LR1575(02) - Fiscal Note - Page 1 of 1