N.Y. ISC Law § 111-A — New York Code / Act ISC / Article 1 / Section 111-A
Notification of prescription drug price increases by manufacturers
Status: in_force

§ 111-a. Notification of prescription drug price increases by\nmanufacturers. (a) This section shall apply to a manufacturer of a\nprescription drug that is purchased or reimbursed in this state by any\nof the following:\n  (1) An insurance company authorized in this state to write accident\nand health insurance, a company organized pursuant to article\nforty-three of this chapter, a municipal cooperative health benefit plan\nestablished pursuant to article forty-seven of this chapter, an\norganization certified pursuant to article forty-four of the public\nhealth law, an institution of higher education certified pursuant to\nsection one thousand one hundred twenty-four of this chapter, or the New\nYork state health insurance plan established pursuant to article eleven\nof the civil service law; or\n  (2) A pharmacy benefit manager, including an entity that directly or\nthrough an intermediary, manages the prescription drug coverage provided\nby a health insurer under a contract or policy delivered or issued for\ndelivery in this state or a health plan subject to section three hundred\nsixty-four-j of the social services law, including the processing and\npayment of claims for prescription drugs, the performance of drug\nutilization review, the processing of drug prior authorization requests,\nthe adjudication of appeals or grievances related to prescription drug\ncoverage, contracting with network pharmacies, and controlling the cost\nof covered prescription drugs.\n  (b) (1) A manufacturer of a prescription drug with a wholesale\nacquisition cost of more than forty dollars for a course of therapy\nshall notify the superintendent, his or her deputy or other officer\ndesignated by the superintendent, if the increase in the wholesale\nacquisition cost of such prescription drug is more than sixteen percent,\nincluding the proposed increase and the cumulative increases that\noccurred within the previous twenty-four months prior to the planned\neffective date of the increase. For purposes of this section, a "course\nof therapy" is defined as either of the following:\n  (i) the recommended daily dosage units of a prescription drug pursuant\nto its prescribing label as approved by the federal Food and Drug\nAdministration for thirty days; or\n  (ii) the recommended daily dosage units of a prescription drug\npursuant to its prescribing label as approved by the federal Food and\nDrug Administration for a normal course of treatment that is less than\nthirty days.\n  (2) (i) The notice required by paragraph one of this subsection shall\nbe provided in writing to the superintendent at least sixty days prior\nto the planned effective date of the increase and shall include the\nproposed increase and the cumulative increases that occurred within the\nprevious twenty-four months.\n  (ii) The superintendent shall forthwith publish the notice required by\nparagraph one of this subsection on the department of financial services\nwebsite within five days of its receipt.\n  (3) (i) The notice required by paragraph one of this subsection shall\ninclude the date of the increase, the current wholesale acquisition cost\nof the prescription drug, and the dollar amount of the future increase\nin the wholesale acquisition cost of the prescription drug.\n  (ii) The notice required by paragraph one of this subsection shall\ninclude a statement regarding whether a change or improvement in the\ndrug necessitates the price increase. If so, the manufacturer shall\ndescribe the change or improvement.\n  (4) Information supplied by a manufacturer pursuant to this section\nthat the manufacturer has reasonably designated as a trade secret shall\nbe considered confidential and a trade secret, shall be exempt from\npublic disclosure and copying under article six of the public officers\nlaw and shall not be disclosed directly or indirectly by the\nsuperintendent.  Notwithstanding the foregoing sentence, the\nsuperintendent shall be permitted to disclose information in an\naggregated format if such aggregate information cannot directly or\nindirectly be used to identify trade secret information related to a\nspecific manufacturer or the manufacturer's prescription drug, including\nbut not limited to any information related to pricing for the\nmanufacturer's prescription drug that has been reasonably designated as\na trade secret.\n  (5) In the event that a manufacturer of a prescription drug subject to\nthis section does not report the information required in paragraph one\nof this subsection, the superintendent is authorized to impose any\npenalty or remedy authorized by this chapter, after notice and a\nhearing, against such manufacturer of up to five thousand dollars per\nday for every day after the reporting period described in this section\nthat the required information is not reported.\n