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To amend titles XVIII and XIX of the Social Security Act to provide that priority research drugs shall not be treated as line extensions of existing drugs for purposes of calculating manufacturer rebates under the Medicare and Medicaid programs, and for other purposes.
Summary
This bill creates a new designation called "priority research drugs" for existing medications that drug manufacturers are investigating for new medical uses. To qualify, a drug must have been approved at least 10 years ago and be studied for a new indication with no currently approved alternative treatments, with the new indication affecting a disease or condition common among beneficiaries of federal health programs such as Medicaid or Medicare. Drugs designated as priority research drugs would be excluded from being classified as line extensions, which exempts them from certain rebate calculations under Medicare and Medicaid. The bill establishes a process for manufacturers to request this designation and requires the federal government to make a decision within 60 days of the request.
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Sponsor (1)
1 cosponsor
Actions (2)
- Apr 1, 2025 Referred to the Committee on Energy and 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. · house
- Apr 1, 2025 Introduced in House
Similar bills (6)
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Text versions (1)
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Full text
IN THE HOUSE OF REPRESENTATIVES
April 1, 2025
Mr. Davis of North Carolina (for himself and Mr. Pfluger) introduced the following bill; which was referred to the Committee on Energy and 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 amend titles XVIII and XIX of the Social Security Act to provide that priority research drugs shall not be treated as line extensions of existing drugs for purposes of calculating manufacturer rebates under the Medicare and Medicaid programs, and for other purposes.
Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the “Old Drugs, New Cures Act”.
SEC. 2. PRIORITY RESEARCH DRUGS.
(a) In General.—Section 1927(c)(2)(C) of the Social Security Act (42 U.S.C. 1396r-8(c)(2)(C)) is amended by inserting the following new clause before the flush matter at the end:
“(iv) Priority research drug.—
“(I) Request for designation.—Not later than 90 days following the date of enactment of this clause, the Secretary shall establish and make effective a process for the manufacturer of a covered outpatient drug to request that the Secretary designate the drug as a priority research drug.
“(II) Designation.—Not later than 60 calendar days after the receipt of a request under subclause (I), the Secretary shall designate a covered outpatient drug as a priority research drug so long as it meets the following criteria: “(aa) As of the date of submission of such request, at least 10 years have elapsed since the date the drug was approved under section 505(c) of the Federal Food, Drug, and Cosmetic Act or section 351(a) of the Public Health Service Act. “(bb) The manufacturer of the drug is investigating such drug under section 505(i) of the Federal Food, Drug, and Cosmetic Act or section 351(a)(3) of the Public Health Service Act for a new indication that would address a significant unmet medical need because there is no alternative drug approved under section 505 of the Federal Food, Drug, and Cosmetic Act or licensed under section 351 of the Public Health Service Act for such indication on the date that the request under subclause (I) was submitted to the Secretary.
“(cc) The new indication described in item (bb) is for a disease or condition that has a high prevalence among beneficiaries of Federal health care programs. For purposes of this clause, a disease or condition has a high prevalence among beneficiaries of Federal health care programs if at least 33 percent of claims in the population targeted by the new indication during the prior calendar year were paid for under—
“(AA) a State plan under this title or a State child health plan under title XXI;
“(BB) part D of title XVIII with respect to an individual who is eligible for subsidies under section 1860D-14;
“(CC) the drug discount program under section 340B of the Public Health Service Act (42 U.S.C. 256b; or
“(DD) a health care program administered by the Department of Veterans Affairs.”.
(b) Exclusion of Priority Research Drugs From Medicaid Definition of Line Extension.—The flush matter at the end of section 1927(c)(2)(C) of the Social Security Act (42 U.S.C. 1396r-8(c)(2)(C)) is amended by inserting “a priority research drug (as designated under clause (iv)) or” after “does not include”.
(c) Exclusion of Priority Research Drugs From Medicaid Best Price Special Rule for Selected Drugs.—Section 1927(c)(1)(C)(ii)(V) of the Social Security Act (42 U.S.C. 1396r-8(c)(1)(C)(ii)(V)) is amended by inserting “unless such drug is also designated as a priority research drug under paragraph (2)(C)(iv) during such period” before the period.
(d) Exclusion of Priority Research Drugs From Medicare Definition of Line Extension.—Section 1860D-14B(b)(5)(B)(ii) of the Social Security Act (42 U.S.C. 1395w-114b(b)(5)(B)(ii)) is amended by inserting “a priority research drug (as designated under section 1927(c)(2)(C)(iv)) or” after “does not include”. <all>
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