Use Sovereignty To reduce Rx Act or the USTRx Act This bill establishes the role of Chief Pharmaceutical Trade Negotiator within the U.S. Trade Representative (USTR) to conduct trade negotiations, enforce trade agreements relating to U.S. pharmaceutical products, and address acts, policies, or practices of high-income countries that adversely impact the market access of U.S. pharmaceutical manufacturers. The USTR must annually compile a list of high-income countries based on official statistics of the International Bank for Reconstruction and Development of the World Bank. Based on that list, the negotiator must submit a report describing (1) such countries' actions and impacts relating to the pharmaceutical trade, and (2) the current status of any responsive actions taken by the United States.