This legislation, titled the "End Price Gouging for Medications Act," requires the Secretary of Health and Human Services to establish annual reference prices for every prescription drug. These reference prices would be primarily determined by identifying the lowest retail list price for the drug among a basket of 12 specified reference countries, provided pricing data is available from at least three of them. If insufficient international data exists, the Secretary would set the price based on factors such as the drug's therapeutic effect, value, patient access, and research and development costs. The established reference prices would apply to covered drugs within various Federal health programs , including Medicare, Medicaid, TRICARE, VA health care, and the Federal Employees Health Benefits Program, ensuring that the retail list price does not exceed the reference price for beneficiaries. Furthermore, drug manufacturers would be obligated to offer prescription drugs at these reference prices to all individuals, including the uninsured and those covered by private health plans, where the total cost (plan coverage plus cost-sharing) cannot exceed the reference price. Non-compliant manufacturers would face substantial civil penalties , with collected funds directed to the National Institutes of Health for drug research and development.