Bill Text: NY S05942 | 2019-2020 | General Assembly | Introduced


Bill Title: Requires certain manufacturers of prescription drugs to notify the drug utilization review board of the proposed increase of the wholesale acquisition cost of such prescription drugs.

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced) 2019-05-16 - REFERRED TO HEALTH [S05942 Detail]

Download: New_York-2019-S05942-Introduced.html



                STATE OF NEW YORK
        ________________________________________________________________________

                                          5942

                               2019-2020 Regular Sessions

                    IN SENATE

                                      May 16, 2019
                                       ___________

        Introduced  by  Sen. SALAZAR -- read twice and ordered printed, and when
          printed to be committed to the Committee on Health

        AN ACT to amend the public health law, in relation to requiring  certain
          manufacturers  of  prescription  drugs  to notify the drug utilization
          review board of the proposed increase  of  the  wholesale  acquisition
          cost of such prescription drugs

          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:

     1    Section 1. The public health law is amended by adding  a  new  section
     2  277-a to read as follows:
     3    § 277-a. Notification of prescription drug price increases by manufac-
     4  turers.  1. This section shall apply to a manufacturer of a prescription
     5  drug that is purchased or reimbursed by any of the following:
     6    (a) An insurance company authorized in this state  to  write  accident
     7  and  health  insurance,  a  company organized pursuant to article forty-
     8  three of the insurance law, a municipal cooperative health benefit  plan
     9  established  pursuant  to  article  forty-seven of the insurance law, an
    10  organization certified pursuant to article forty-four of  this  chapter,
    11  an  institution  of  higher  education certified pursuant to section one
    12  thousand one hundred twenty-four of the insurance law, or the  New  York
    13  state  health  insurance  plan established pursuant to article eleven of
    14  the civil service law; or
    15    (b) A pharmacy benefit manager, including an entity that  directly  or
    16  through an intermediary, manages the prescription drug coverage provided
    17  by  a  health insurer under a contract or policy delivered or issued for
    18  delivery in this state or a health plan subject to section three hundred
    19  sixty-four-j of the social services law, including  the  processing  and
    20  payment of claims for prescription drugs, the performance of drug utili-
    21  zation  review, the processing of drug prior authorization requests, the
    22  adjudication of appeals  or  grievances  related  to  prescription  drug

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11426-01-9

        S. 5942                             2

     1  coverage,  contracting with network pharmacies, and controlling the cost
     2  of covered prescription drugs.
     3    2. (a) A manufacturer of a prescription drug with a wholesale acquisi-
     4  tion cost of more than forty dollars for a course of therapy shall noti-
     5  fy  the  drug  utilization review board if the increase in the wholesale
     6  acquisition cost of such prescription drug is  more  than  ten  percent,
     7  including  the  proposed  increase  and  the  cumulative  increases that
     8  occurred within the previous two calendar years  prior  to  the  current
     9  year.  For purposes of this section, a "course of therapy" is defined as
    10  either of the following:
    11    (i) the recommended daily dosage units of a prescription drug pursuant
    12  to its prescribing label as approved by the federal Food and Drug Admin-
    13  istration for thirty days; or
    14    (ii) the recommended daily dosage units of a prescription drug  pursu-
    15  ant  to  its  prescribing label as approved by the federal Food and Drug
    16  Administration for a normal course of treatment that is less than thirty
    17  days.
    18    (b) The notice required by paragraph (a) of this subdivision shall  be
    19  provided  in writing to the drug utilization review board at least sixty
    20  days prior to the planned effective date of the increase.
    21    (c) (i) The notice required by paragraph (a) of this subdivision shall
    22  include the date of the increase, the current wholesale acquisition cost
    23  of the prescription drug, and the dollar amount of the  future  increase
    24  in the wholesale acquisition cost of the prescription drug.
    25    (ii)  The  notice  required by paragraph (a) of this subdivision shall
    26  include a statement regarding whether a change  or  improvement  in  the
    27  drug  necessitates  the  price  increase.  If so, the manufacturer shall
    28  describe the change or improvement.
    29    (d) In the event that a manufacturer of a prescription drug subject to
    30  this section does not report the information required in  paragraph  (a)
    31  of  this  subdivision,  the  commissioner  is authorized to levy a civil
    32  penalty, after notice and a hearing, against such manufacturer of up  to
    33  one  thousand  dollars  per day for every day after the reporting period
    34  described in this section that the required information is not reported.
    35    § 2. This act shall take effect immediately.
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