; (iii) which conditions payment on the achievement of at least 2 relevant clinical parameters (as defined in subparagraph (C)); (iv) which provides that— (I) the State plan will directly reimburse the manufacturer for the drug; or (II) a third party will reimburse the manufacture in a manner approved by the Secretary; and (v) is approved by the Secretary in accordance with paragraph (2). (F) Total installment year amount The term total installment year amount means, with respect to a risk-sharing value-based payment agreement for the purchase of a covered outpatient drug and an installment year, an amount equal to the product of— (i) the unit price of the drug charged under the agreement; and (ii) the number of units of such drug administered under the agreement during such installment year. . (b) Conforming amendments (1) Section 1903(i)(10)(A) of the Social Security Act ( 42 U.S.C. 1396b(i)(10)(A) ) is amended by striking or unless section 1927(a)(3) applies and inserting , section 1927(a)(3) applies with respect to such drugs, or such drugs are the subject of a risk-sharing value-based payment agreement under section 1927(l) . (2) Section 1927(b) of the Social Security Act ( 42 U.S.C. 1396r–8(b) ) is amended— (A) in paragraph (1)(A), by inserting but excluding any drugs for which payment is made by a State under a risk-sharing value-based payment agreement under subsection (l)) after for coverage of such drugs ; and (B) in paragraph (3)— (i) in subparagraph (C)(i), by inserting or subsection (l)(2)(A) after subparagraph (A) ; and (ii) in subparagraph (D), in the matter preceding clause (i), by inserting , under subsection (l)(2)(A), after under this paragraph .