S. 694 — PLASMA Act

This section establishes a phase-in schedule for manufacturer discounts on plasma-derived products under the Medicare Part D manufacturer discount program (i.e., requires drug manufacturers to discount high-cost applicable drugs selected for price negotiation when dispensed to non-LIS beneficiaries). For plasma-derived products (biological products derived from human whole blood or plasma and marketed as of August 16, 2022), the discounted price equals the specified percentage of the negotiated price—(1) for beneficiaries who have not reached the annual out-of-pocket threshold, 99% in 2026, 98% in 2027, 95% in 2028, 92% in 2029, and 90% in 2030 and subsequent years; and (2) for beneficiaries who have reached the threshold, 99% in 2026, 98% in 2027, 95% in 2028, 92% in 2029, 90% in 2030, 85% in 2031, and 80% in 2032 and subsequent years. (Thus, manufacturer discounts phase in from 1% of negotiated price to 10% pre-threshold and 20% post-threshold.) The provision excludes drugs dispensed to low-income subsidy beneficiaries or by specified small manufacturers.