109th CONGRESS
1st Session
H. R. 417
To provide incentives for investment in research and development
for new medicines, to enhance access to new medicines, and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
January 26, 2005
Mr. SANDERS introduced the following bill; which was referred to the Committee
on Energy and Commerce, and in addition to the Committee on the Judiciary,
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 incentives for investment in research and development
for new medicines, to enhance access to new medicines, 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 `Medical Innovation Prize Act of 2005'.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Retail sales of prescription drugs totaled $179.2 billion in 2003, up
10.7 percent over 2002 and over 4 times as much as the amount spent in 1990.
(2) Retail prescription prices, including both manufacturer price changes
for existing drugs and changes in use to newer, higher-priced drugs, have
increased an average of 7.4 percent a year from 1993 to 2003, nearly triple
the average inflation rate of 2.5 percent.
(3) United States spending for prescription drugs is projected to increase
by 10.7 percent annually between 2004 and 2013.
(4) From 1993 to 2003, the number of prescriptions purchased increased 70
percent (from 2.0 billion to 3.4 billion), compared to a United States population
growth of 13 percent. The average number of prescriptions per capita increased
from 7.8 to 11.8.
(5) Prescription drug expenditures rose faster than overall national health
spending from 1993 to 2003.
(6) In 2003, prescription drugs accounted for 11 percent of national health
spending, but 23 percent of total out-of-pocket spending by patients.
(7) Consumers paid 30 percent of prescription drug costs in 2003--$53.2
billion of the $179.2 billion spent on prescription medicines.
(8) Implementation of the new drug benefit in Medicare is likely to increase
aggregate drug spending.
(9) Retail sales of prescription drugs in the United States equaled approximately
1.5 percent of United States gross domestic product in 2003.
(10) High prices on medicines discourage employers from providing health
insurance coverage to workers.
(11) High prices on medicines lead to restrictions on use because of price
barriers and rationing by third parties that subsidize or insure purchases
of medicines.
(12) In a 2003 survey, 37 percent of the uninsured said they did not fill
a prescription because of cost, compared to 13 percent of the insured.
(13) According to the Food and Drug Administration, from 1993 to 2002, approximately
70 percent of all new drugs approved did not offer significant therapeutic
benefits over existing medicines.
(14) Drug prices are far higher in the United States than in any other developed
country because it is the only country that grants pharmaceutical companies
a monopoly in the market, based on patent protection, without any corresponding
restriction on prices.
(15) Pharmaceutical manufacturers have distorted the quality of drug research
in many instances, such as with the drug Celebrex. Often due to the influence
of the funding source, drug research has been shown to suffer from concealed
and distorted findings, bias, conflicts of interest, and secrecy.
(16) There are important gaps in treatments for many severe illnesses.
(17) The existence of neglected diseases in other regions of the world leads
to immense suffering and death, undermines development, shrinks potential
markets, and has long-term negative effects for United States security.
(18) Emerging diseases, viral mutations, and food-borne disease transmitted
through international trade have negative effects on Americans and must
be combated before they arrive on the Nation's shores.
SEC. 3. PURPOSE.
The purpose of this Act is to provide incentives to invest in research and
development of new medicines by establishment of a Medical Innovation Prize
Fund and to enhance access to such medicines by allowing any person in compliance
with Food and Drug Administration requirements to manufacture, distribute,
or sell an approved medicine.
SEC. 4. ELIMINATION OF EXCLUSIVE RIGHTS TO MARKET DRUGS AND BIOLOGICAL PRODUCTS.
(a) No Right of Exclusive Marketing- No person shall have the right to exclusively
manufacture, distribute, sell, or use a drug, a biological product, or a manufacturing
process for a drug or biological product in interstate commerce, notwithstanding
title 35 of the United States Code, relevant provisions of the Federal Food,
Drug, and Cosmetic Act, as amended by the Drug Price Competition and Patent
Term Restoration Act of 1984 (Public Law 98-417; 98 Stat. 1585; also referred
to as the `Hatch-Waxman Act' ) and the Medicare Prescription Drug, Improvement,
and Modernization Act of 2003 (Public Law 108-173; 117 Stat. 2066), such as
the exclusive rights to rely on health registration data or the 30-month stay-of-effectiveness
period for Orange Book patents, and any other provision of law providing any
patent right or exclusive marketing period for any drug, biological product,
or manufacturing process for a drug or biological product, such as pediatric
extensions or orphan drug marketing exclusivity.
(b) Remuneration- A person eligible for prize payments from the Fund for Medical
Innovation Prizes under section 9 shall receive such payments--
(1) in lieu of any remuneration the person would have received (but for
the operation of subsection (a)) by reason of the exclusive marketing, distribution,
sale, or use of the drug, biological product, or manufacturing process involved;
and
(2) in addition to any remuneration the person receives by reason of the
nonexclusive marketing, distribution, sale, or use of the drug, biological
product, or marketing process.
(c) Application- This section applies only with respect to the marketing,
distribution, sale, or use of a drug, a biological product, or a marketing
process that occurs on or after October 1, 2007.
SEC. 5. FUND FOR MEDICAL INNOVATION PRIZES.
(a) Establishment- There is hereby established in the Treasury of the United
States a revolving fund to be known as the Fund for Medical Innovation Prizes,
which shall consist of amounts appropriated to the Fund and amounts credited
to the Fund under subsection (c).
(b) Availability of Funds- Amounts in the Fund shall be available to the Board,
subject to section 16(b), for the purpose of carrying out this Act.
(c) Amounts Credited to Fund- The Secretary of the Treasury shall credit to
the Fund the interest on, and the proceeds from sale or redemption of, obligations
held in the Fund.
SEC. 6. BOARD OF TRUSTEES FOR THE FUND FOR MEDICAL INNOVATION PRIZES.
(a) Establishment- There is hereby established (as a permanent, independent
establishment in the executive branch) a Board of Trustees for the Fund for
Medical Innovation Prizes.
(b) Duties- The Board shall--
(1) award prize payments for medical innovation in accordance with this
Act; and
(2) submit a report to the Congress under section 14.
SEC. 7. MEMBERSHIP AND STAFF OF BOARD.
(a) Membership- The Board shall be composed of 13 members as follows:
(1) The Administrator of the Centers for Medicare & Medicaid Services.
(2) The Commissioner of Food and Drugs.
(3) The Director of the National Institutes of Health.
(4) The Director of the Centers for Disease Control and Prevention.
(5) Nine members, appointed by the President, with the advice and consent
of the Senate, as follows:
(A) Three representatives of the business sector.
(B) Three representatives of the private medical research and development
sector, including at least one representative of the nonprofit private
medical research and development sector.
(C) Three representatives of consumer and patient interests, including
at least one representative of patients suffering from orphan diseases.
(1) IN GENERAL- Except as provided in paragraph (2), each member appointed
to the Board under subsection (a)(5) shall be appointed for a term of 4
years.
(2) TERMS OF INITIAL APPOINTEES- As designated by the President at the time
of appointment, of the members first appointed to the Board under subsection
(a)(5)--
(A) 5 shall be appointed for a term of 4 years; and
(B) 4 shall be appointed for a term of 2 years.
(c) Vacancies- Any member of the Board appointed to fill a vacancy occurring
before the expiration of the term for which the member's predecessor was appointed
shall be appointed only for the remainder of that term. A member of the Board
may serve after the expiration of that member's term until a successor has
taken office.
(d) Basic Pay- Members of the Board shall each be paid not less than the daily
equivalent of level IV of the Executive Schedule for each day (including travel
time) during which they are engaged in the actual performance of duties vested
in the Board.
(e) Travel Expenses- Each member of the Board shall receive travel expenses,
including per diem in lieu of subsistence, in accordance with applicable provisions
under subchapter I of chapter 57 of title 5, United States Code.
(f) Chairperson; Officers- The members of the Board shall elect the Chairperson
and any other officers of the Board. The Chairperson and any such officers
shall be elected for a term of 2 years.
(g) Staff- The Board may appoint and fix the pay of such additional personnel
as the Board considers appropriate. The staff of the Board shall be appointed
subject to the provisions of title 5, United States Code, governing appointments
in the competitive service, and shall be paid in accordance with the provisions
of chapter 51 and subchapter III of chapter 53 of that title relating to classification
and General Schedule pay rates.
(h) Experts and Consultants- The Board may procure temporary and intermittent
services under section 3109(b) of title 5, United State Code.
SEC. 8. POWERS OF BOARD.
(a) Hearings and Sessions-
(1) IN GENERAL- The Board may, for the purpose of carrying out this Act,
hold hearings, sit and act at times and places, take testimony, and receive
evidence as the Board considers appropriate.
(2) FIRST MEETING- Not later than 30 days after the initial 9 members of
the Board under section 7(a)(5) have been appointed and confirmed, the Board
shall conduct its first meeting.
(b) Policies and Procedures-
(1) IN GENERAL- Not later than 1 year after the initial 9 members of the
Board under section 7(a)(5) have been appointed and confirmed, the Board
shall establish such policies and procedures as may be appropriate to carry
out this Act.
(2) MAJORITY VOTE- The policies and procedures of the Board shall require
that any determination of the Board be made by not less than a majority
vote of the members of the Board.
(3) ADMINISTRATIVE PROCEDURES- The policies and procedures of the Board
shall comply with subchapter II of chapter 5 of title 5, United States Code.
(4) TRANSPARENCY- The policies and procedures of the Board shall--
(A) comply with sections 552 and 552b of title 5, United States Code (commonly
referred to as the `Freedom of Information Act' and the `Government in
the Sunshine Act', respectively); and
(B) ensure that the proceedings and deliberations of the Board are transparent
and are supported by a description of the methods, data sources, assumptions,
outcomes, and related information that will allow the public to understand
how the Board reaches its criteria-setting and award decisions.
(c) Expert Advisory Committees- To assist the Board in carrying out this Act,
the Board shall establish independent expert advisory committees, including
committees on the following:
(1) Economic evaluation of therapeutic benefits.
(2) Business models and incentive structures for innovation.
(3) Research and development priorities.
(5) Financial control and auditing.
(d) Powers of Members and Agents- Any member or agent of the Board may, if
authorized by the Board, take any action which the Board is authorized to
take by this Act.
(e) Mails- The Board may use the United States mails in the same manner and
under the same conditions as other departments and agencies of the United
States.
SEC. 9. PRIZE PAYMENTS FOR MEDICAL INNOVATION.
(a) Award- For fiscal year 2007 and each subsequent fiscal year, the Board
shall award to persons described in subsection (b) prize payments for medical
innovation relating to a drug, a biological product, or a new manufacturing
process for a drug or biological product.
(b) Eligibility- To be eligible to receive a prize payment under this section
for medical innovation relating to a drug, a biological product, or a manufacturing
process, a person shall be--
(1) in the case of a drug or biological product, the first person to receive
market clearance; or
(2) in the case of a manufacturing process, the holder of the patent.
(c) Criteria- The Board shall determine by regulation criteria for selecting
recipients, and determining the amount, of prize payments under this section.
Such criteria shall include consideration of the following:
(1) The number of patients who benefit from a drug, biological product,
or manufacturing process including (in cases of global neglected diseases,
global infectious diseases, and other global public health priorities) the
number of non-United States patients.
(2) The incremental therapeutic benefit of a drug, biological product, or
manufacturing process, compared to existing drugs, biological products,
and manufacturing processes available to treat the same disease or condition.
(3) The degree to which the drug, biological product, or manufacturing process
addresses priority health care needs, including--
(A) current and emerging global infectious diseases;
(B) severe illnesses with small client populations (such as indications
for which orphan designation has been granted under section 526 of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 360bb)); and
(C) neglected diseases that primarily afflict the poor in developing countries.
(4) Improved efficiency of manufacturing processes for drugs or biological
processes.
(d) Requirements- In awarding prize payments under this section, the Board
shall comply with the following:
(1) In cases where a new drug, biological product, or manufacturing process
offers an improvement over an existing drug, biological product, or manufacturing
process and the new drug, biological product, or manufacturing process competes
with or replaces the existing drug, biological product, or manufacturing
process, the Board shall continue to make prize payments for the existing
drug, biological product, or manufacturing process to the degree that the
new drug, biological product, or manufacturing process was based on or benefited
from the development of the existing drug, biological product, or manufacturing
process.
(2) The Board may not make prize payments based on the identity of the person
who manufactures, distributes, sells, or uses the drug, biological product,
or manufacturing process involved.
(3) The Board may award prize payments for a drug, a biological product,
or a manufacturing process for not more than 10 fiscal years, regardless
of the term of any related patents.
(4) For any fiscal year, the Board may not award a prize payment for any
single drug, biological product, or manufacturing process in an amount that
exceeds 5 percent of the total amount appropriated to the Fund for that
year.
(5) For every drug or biological product that receives market clearance,
the Board shall determine whether and in what amount to award a prize payment
for the drug or biological product not later than the end of the fourth
full calendar-year quarter following the calendar-year quarter in which
the drug or biological product receives market clearance.
SEC. 10. PRIZES FOR PRIORITY RESEARCH AND DEVELOPMENT.
(a) Minimum Levels of Funding- For fiscal year 2007 and each subsequent fiscal
year, the Board shall establish and may periodically modify minimum levels
of funding under section 9 for priority research and development.
(b) Initial Minimum Levels- Of the amount appropriated to the Fund for a fiscal
year, the Board shall use (subject to establishment or modification of an
applicable minimum level of funding under subsection (a)) not less than--
(1) 4 percent of such amount for global neglected diseases;
(2) 10 percent of such amount for orphan drugs; and
(3) 4 percent of such amount for global infectious diseases and other global
public health priorities, including research on AIDS, AIDS vaccines, and
medicines for responding to bioterrorism.
(c) Public Input; Recommendations- The advisory committee on research and
development priorities (established pursuant to section 8(c)) shall--
(1) solicit public input on research and development priorities; and
(2) periodically recommend to the Board changes in the minimum levels of
funding for prizes for priority research and development.
(d) Procedures- The Board shall adopt procedures to establish and periodically
modify minimum levels of funding under section 9 for priority research and
development.
SEC. 11. SPECIAL TRANSITION RULES.
(a) In General- A drug or biological product that is already on the market
by October 1, 2007, shall remain eligible for prize payments for not more
than 10 fiscal years, consistent with section 9(d)(3).
(b) Determination of Value- In determining the amount of a prize payment for
a drug or biological product described in subsection (a), the Board shall
calculate the incremental value of the drug or biological product as of the
date on which the drug or biological product was first introduced in the market.
(c) Maximum Amount- For drugs and biological products described in subsection
(a), the Board may award--
(1) of the amount appropriated to the Fund for fiscal year 2007, not more
than 90 percent of such amount; and
(2) of the amount appropriated to the Fund for each of the succeeding 9
fiscal years, not more than a percentage of such amount that is 9 percent
less than the percentage applicable to the preceding fiscal year under this
subsection.
SEC. 12. ARBITRATION.
In the case of a drug that is already on the market by October 1, 2007, and
subject to patents owned by a party other than the person who first received
market clearance for the drug, the Board shall establish an arbitration procedure
to determine an equitable division of any prize payments among the patent
owners and the person who first received market clearance for the drug.
SEC. 13. ANNUAL AUDITS BY GAO.
(a) Audits- The Comptroller General of the United States shall conduct an
audit of the Board each fiscal year to determine the effectiveness of the
Board--
(1) in bringing to market drugs, vaccines, other biological products, and
new manufacturing processes for medicines in a cost-effective manner; and
(2) in addressing society's medical needs, including global neglected diseases
that afflict primarily the poor in developing countries, indications for
which orphan designation has been granted under section 526 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360bb), and global infectious diseases
and and other global public health priorities.
(b) Reports- The Comptroller General of the United States shall submit a report
to the Congress each fiscal year on the results of each audit conducted under
subsection (a).
SEC. 14. REPORT TO CONGRESS.
Not later than 1 year after the date of the enactment of this Act, the Board
shall submit to the Congress a report containing the findings, conclusions,
and recommendations of the Board regarding the implementation and administration
of this Act, including recommendations for such legislative and administrative
action as the Board determines to be appropriate.
SEC. 15. DEFINITIONS.
(1) The term `biological product' has the meaning given to that term in
section 351 of the Public Health Service Act (42 U.S.C. 262).
(2) The term `Board' means the Board of Trustees for the Fund for Medical
Innovation Prizes established by section 6.
(3) The term `drug' has the meaning given to that term in section 201 of
the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321).
(4) The term `Fund' means the Fund for Medical Innovation Prizes established
by section 5.
(5) The term `market clearance' means approval of an application under section
505 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355) or approval
of a biologics license application under subsection (a) of section 351 of
the Public Health Service Act (42 U.S.C. 262).
SEC. 16. FUNDING.
(1) START-UP COSTS- For fiscal year 2006, there are authorized to be appropriated
to the Fund for Medical Innovation Prizes such sums as may be necessary
to carry out this Act.
(2) PROGRAM IMPLEMENTATION- For fiscal year 2007 and each subsequent fiscal
year, there is appropriated to the Fund for Medical Innovation Prizes, out
of any funds in the Treasury not otherwise appropriated, an amount equal
to the amount that is 0.5 percent of the gross domestic product of the United
States for the preceding fiscal year (as such amount is determined by the
Secretary of Commerce).
(b) Availability- Funds appropriated to the Fund for Medical Innovation Prizes
for a fiscal year shall remain available for expenditure in accordance with
this Act until the end of the 3-year period beginning on October 1 of such
fiscal year. Any such funds that are unexpended at the end of such period
shall revert to the Treasury.
END