Bill > HR5372

This bill, the Expanding Seniors' Access to Lower Cost Medicines Act of 2023, aims to amend Title XVIII of the Social Security Act to facilitate midyear formulary changes for biosimilars. The key provision of this bill allows prescription drug plan (PDP) sponsors to change the preferred or tiered cost-sharing status of a reference biological product (the original drug) if they add a biosimilar biological product (a highly similar but less expensive version of the original drug) to the formulary at the same or higher preferred status or lower cost-sharing tier as the reference biological product. This change can be made at any time after the first 60 days of the plan year, subject to certain requirements. The bill also exempts the implementation of this amendment from the Paperwork Reduction Act, allowing the Secretary of Health and Human Services to implement it through program instruction or other means.

Business and Industry, Health and Social Services

https://www.congress.gov/bill/118th-congress/house-bill/5372/all-info