Protects access to new medicines and cures and lowers out of pocket spending and strengthens transparency and accountability and champions competition. H. R. 19 acts in the interest of hardworking americans. I urge my colleagues to support this bipartisan, commonsense amendment. I yield back. The chair the gentlewoman from california is recognized. Ms. Porter claims that h. R. 3 ill stop cures is fear mongering. H. R. 3 makes substantial more ment to help create cures and most importantly will make sure those cures can actually help people in their lives. Fair that the government, elected by the taxpayers, and the appointed by , elected officials, should get to negotiate drug prices, and it not come at the expense of innovation. I reserve the balance of my time. He chair the gentlewoman reserves. The gentleman from oregon. Mr. Walden i reserve. The chair the gentleman reserves. California man from is recognized. Speaker, how r. Much time remains . The chair the gentlewoman has 30 seconds remaining. Ms. Porter i look forward to my colleagues on both sides of the aisle to continue to come up with ways to innovation and support the kind of innovation thats happening in orange county, the area that i represent. But we have to tackle the fundamental problem here, which is that pharmaceutical companies are gouging americans. They are overcharging them, and theyre leaving lifesaving drugs hands of the American People each and every day. Tackle ndment does not that fundamental problem. Today, nine out of 10 Big Pharmaceutical Companies spend marketing, sales, and overhead than they do on research. Packaged to support the of h. R. 3, because it will tackle the fundamental problem f permitting price negotiation and making drugs more affordable americans. I yield back. The chair the gentleman from oregon is recognized. Mr. Walden thank you, mr. Chairman. I yield myself such time as i may consume. Ours is the only bipartisan bill. 36 different provisions passed out of ways and means or energy with mmerce committee unanimous bipartisan support. All these provisions cosponsored by democrats. 17 different bills passed out of the house of representatives, bipartisan support in here. Package. He bipartisan i have always worked across the line to get things done, whether 21st in opioids or century cures or modernizing the f. D. A. I pledge to continue to do that. The floor n bill on today is h. R. 3. The facts of the matter show new innovationny in america and new cures for patients whose lives are on the line. Vote on h. R. 3 and a yes on the substitute. Question is on the amendment offered by the gentleman from oregon. Those in favor say aye. Those opposed, no. In the opinion of the chair, the have it. Mr. Walden mr. Chairman, i ask for the yeas and nays. A recorded vote. The chair pursuant to clause 6 of rule 18, further proceedings on the amendment offered by the gentleman from oregon will be postponed. T is now in order to consider amendment number 2 printed in 116334. F house report for what purpose does the gentleman from new york seek recognition . Mr. Chair, i have an amendment at the desk. The chair the clerk will designate the amendment. The clerk amendment number 2 in part b of house eport 116334 offered by mr. Tonko of new york. The chair pursuant to House Resolution 758, the gentleman york, mr. Tonko, and a member opposed, will each control five minutes. Recognizes the gentleman from new york. Mr. Tonko thank you, mr. Chair. I yield myself such time as i may consume. Without objection. Mr. Tonko despite the passage bilogics price xe biologics price innovation act through the Affordable Care ct which created the modern pathway by bringing biosimilar drugs to market, consumers in are still not es reaping the cost saving benefits biosimilars ature market would provide. As of may, only 19 biosimilars the f. D. A. Pproved by many of those that have been approved are not on the market of reasons. Economics 101 teaches us when ore competition is introduced into the market, prices come down. We have seen this with the of the ming success Generic Pharmaceuticals market were e a home, and seeing it with biosimilars in other parts of the globe. In europe, for example, the of biosimilar ompetition for hew mara humara led to the manufacture dropping it. In the ately, here United States, biosimilars still ery low market share and utilization, despite the fact they could generate muchneeded avings for patients and for taxpayers. If we want to continue to meaningfully lower drug costs american patients, congress can and should do more to create that is environment ripe for greater biosimilar adoption. Underlying rationale behind my amendment, which is based on legislation i ntroduced with congressman bob gibbs, known as the star ratings for biosimilars act. The amendment would require department of health and Human Services to incorporate into the existing star Rating System for Medicare Advantage and part d lans a measure that evalue waits how plans pro evaluates how plans promote access to biosimilar drugs. In creating such a measure, at things d look suc such at tier placement, cost sharing, and other utilization techniques. By evaluating plans on biosimilar access, this health t would motivate plans to improve performance and implement changes to improve biosimilars, creating a policy environment ripe for biosimilar development. A similar measure has already senate pted by the finance committee. As they work through their Prescription Drug legislation. From some criticism hat the star Rating System has traditionally not been used for this type of measure. To that, i would contend that tar ratings have already been used in several ways to influence plan behavior and quality such as evaluating plans on how they screenings, care coordination and medicare management, for example. These metrics are incent plans for beneficiary help. Access to affordable medicatio patients will abstain from needed medications if simply too high. The. B. O. Score for underlying legislation makes this connection crystal clear. Evaluating plans on biosimilar access, we are ensuring that patients have the that will they need allow them to live healthier lives. Simply urge would my colleagues to support this important amendment that will elp lay the groundwork for greater biosimilar adoption and continue to lower drug costs for patients. Obviously a common cause for each and every person in this chamber. I reserve mr. Chair, the balance of my time. The gentleman reserves. The gentleman from oregon. Mr. Walden thank you. Reserve. The chair does the gentleman claim time in opposition . Do. Walden oh, i i claim time in opposition and i reserve the balance of my time. The chair the gentleman reserves. The gentleman from new york is recognized. Chair, i believe we have no other members speak on our side. Mr. Walden mr. Chair, i yield myself such time as i may consume. The chair without objection. Mr. Walden i commend my friend, mr. He is my tonko. He is a very thoughtful legislator. A lot of together on bills. He withdrew this in committee 3 and i continue onoffer to sit down and work the language. As constructed, it could have consequences, including increasing drug prices, which none of us want gentlemans goal measure. Star rating are a good tool for onsumers and the government, but to apply an automatic star rating change to a plans coverage of biosimilars could them the manufacturer too much negotiating leverage and we that. Want to do this would be a major shift in the type of plans would be rated on. Affect the way they negotiate with manufacturers and unfortunately, we believe, not in a way, lower cost for consumers in Medicare Advantage. Star rating is an important factor when they choose their plan. If a plan knows they will be reimbursed based on the coverage of one biosimilar, they dont have much ground to to d on if they want negotiate the cost of that drug down to the benefit of the patient. Of means the manufacturer the biosimilar has all the leverage, and they can keep the price high knowing theyll placed on the plans formulary because the plan is being rated on it. Right. Tleman is we should do more to ensure biosimilar coverage in this country. An important issue. Again, id be happy to work with him. Side of s on the other the aisle on this and many other provisions. Id recognize the gentleman from montana for how remains . For three minutes. From air the gentleman montana is recognized. Gianforte the cost of Prescription Drugs have ontinued to rise, putting montanans with Critical Health issues in jeopardy. Senior ly heard from a in libby, montana, with colon cancer. 2010 and hissed in disease has bankrupt his family. Takes costs ug he 17,000 per montana. Its the only drug that works cancer and medicare only covers 11,000. He is forced to fight against the give up his fight against pay an extra 6,000 a month for a lifesaving drug. A year. N extra 72,000 as he put it, i find it rather sellncerting that one must his home and all his possessions cancer. Survive i agree, this has to stop. Put no ld have to one should have to end up like my constituent in libby, and the that this would we could lower prescription costs while outofpocket costs by the end of 2019. Its also disheartening that working in have been good faith all year on a ipartisan basis to do just that. Unfortunately, house democrats, led by speaker nancy pelosi, are partisan politics in front of patients. Er plan would have devastating consequences for montanans. It will lead to rationing of medication, Big Government price fixing, and government bureaucrats between medication. The truth is her partisan bill house ver move past the floor. We have heard from majority leader mcconnell that the pelosi on arrival in the senate, and it doesnt have a chance of being signed into law President Trump. Unfortunately, as we wait on democrats to act in a bipartisan continue to rise and hardworking montanans continue o choose between their needed medication and paying their bills. On the other hand, the republicans have introduced the costs and more cures act. This is a bipartisan bill that law by the ned into end of 2019. His bill increases transparency, encouraging innovation for new drugs and cures and places a cap on costs. outofpocket ive also been working to lower true and shed light on the cost of Prescription Drugs. Last week, i introduced a legislation to bring muchneeded transparency into the practice of middle men in pharmaceutical supply chain called pharmacy benefit managers. Competition ases between p. B. M. s and lower costs for patients. Winwin. Y a waiting any longer to pass bills that lower costs for patients to political points is unacceptable. Enough is enough. Lets stop the political theater get back to work. The chair the gentlemans time has expired. Is gentleman from oregon recognized. Mr. Walden ill continue to reserve. The chair the gentleman reserves. The gentleman from new york is recognized. R. Tonko thank you, mr. Chair. We have no further speakers on this side. F mr. Walden is prepared to close, ill further reserve. The chair the gentleman reserves. R. Walden i believe i have the right to close. The chair the gentleman is correct. Mr. Walden so ill reserve and et my friend from new york close. Mr. Tonko thank you, mr. Chair. Opinions ofpect the mr. Walden. We have worked in a bipartisan before on several issues energy and commerce, but i believe the claim that this simply crease costs is false. Like the Senate Finance committee thats moving forward this proposition on biosimilars, we believe it is a costs. Lower to date, the 9 11 Biosimilars Biosimilars access is at an average of 19 discount. A false claim that a biosimilar would not not launch at a lower price. Certainly we must do better. Were reminded constantly that better, we must do better, as the namesake of this legislation had constantly us. Ored representative Elijah Cummings always knew that we needed to for the American Public. That is why we need to pass this amendment. Back, mr. I yield chair. The chair the gentleman yields. The gentleman from oregon is recognized. R. Walden thank you, mr. Chairman. And i understand my friends comments. Accidentallynts to create a situation where prices go up rather than down. Intent. Thats not his we have that concern on this side. Perhaps we can work this out long the way and get to the same place here because i think we share a similar goal, and i yield back the balance of my time. Yields. R the gentleman and the question is on the amendment offered by the new york. From those in favor say aye. Those opposed, no. In the opinion of the chair, the ayes have it. The amendment is agreed to. It is now in order to consider amendment number 3 printed in part b of house report 116334. For what purpose does the gentleman from california seek recognition . Mr. Chairman, i have an amendment at the desk. The speaker pro tempore the clerk will the chair the clerk will designate the amendment. The clerk amendment number 3 printed in house report 116334 offered by mr. Peterser of california peters of california. The chair pursuant to House Resolution 758, the gentleman from california, mr. Pete, and a member opposed each will control five minutes peters, and a member opposed each will control five minutes. The chair now recognizes the gentleman from california. Mr. Peters thank you, mr. Speaker. I yield myself such time as i may consume. H. R. Is 3 is not perfect, no bill is. But i will support it today because its our best chance to get moving on the very pressing issue of high Prescription Drug prices. I hope the senate will work with us in a goodfaith manner to come up with a final bill that both lowers prices and preserves incentives for innovation. The concerns and some outstanding questions about the effect of this bill on innovation in the private sector are legitimate. My colleagues have referenced the c. B. O. Studies, also the California Life Science Association released a report in october that predicted that h. R. 3 would make Drug Development particularly challenging for small and emerging companies in california. The amendment i offer today will go a long way toward preserving and supporting biopharmaceutical innovation and thats not an be a strax it. Can be measured in jobs, breakthrough cures and even state of the art research facilities. Innovation, research and development are the Economic Life blood of california and particularly san diego. Over the past decade, california firms have received more than 30 of total biotech investment in the country, and in san diego county, there are over 48,000 jobs in the Life Sciences sector, supported by 1. 5 billion in Venture Capital. In san diego alone we have five institutions that rank among the top recipients of the National Institutes of Health Funding in the country and they are doing amazing things. One la jolla based research and Development Facility in my district recently launched a onetime gene replacement therapy that essentially halts the progression of a rare and deadly genetic childhood disorder, spinal muscular atrophy. This company is also currently investing in research to cure a genetic form of a. L. S. If we arent cable, arent careful, we might put those kind of breakthrough therapies at risk of never treating a single patient. From n. I. H. And Academic Research institutions to philanthropy and biopharmaceutical industries, theres a network of capital today in the public and private sectors that supports innovation. At the risk of oversimplifying, the n. I. H. Focuses on basic biomedical science, investigating the underlying mechanisms of disease, while smaller Biotech Companies supported by Institutional Investors take the basic science to the preclinical and early phase stages of Drug Development. Drug companies later conduct laterStage Research, Fund Clinical trials and invest in startups. These financial backers, like Drug Companies and Venture Capitalists, are important because they can help close the funding gap that exists between Preclinical Research and the early and later stage Clinical Trials. Now, if h. R. 3 predicts changes investor behavior as some predict, this could widen the gap for smaller Biotech Companies, the socalled valley of death, and i think we can all agree that these are consequences we want to avoid. Securing funding for the high cost of Clinical Trials is often cited as the key hurdle facing smaller Biotech Companies at the precipice of the socalled valley of death. While the biopharmaceutical industry and the federal government both Fund Clinical trials, n. I. H. s ability to bring drugs to market is constrained by its limited budget. And a mandate to carry out its core mission of advancing biomedical research, which is not necessarily the same as bringing drugs to market. Over time, these limitations have resulted in the declining number of n. I. H. Sponsored Clinical Trials. The biopharma industry is really good at bringing drugs to market because it can afford expensive failures. The federal government is really good at research and development, because it can ignore constraining signals of the commercial market. We do patie