Superintendent Linda A. Lacewell today announced that the New York State Department of Financial Services (DFS) has formed the Office of Pharmacy Benefits (OPB), which will immediately begin investigations into spikes in drug prices impacting New York consumers and insurance markets.  The Superintendent also announced the first appointments to the Drug Accountability Board (DAB), a nine-member board of outside experts with varied expertise that will provide guidance and advice on drug pricing as the Department undertakes this critical new function.  

“It is unacceptable that consumers have to pay for these price increases through their insurance premiums or out of pocket when manufacturers and others spike prices with no justification or explanation,” said Superintendent Lacewell. “When manufacturers play with prices to make a profit, it’s not just dollars and cents they are playing with, it is people’s lives.”      

Pursuant to new legislation, championed by Governor Cuomo in the Executive Budget this year, the Superintendent, in her discretion, has the authority to launch an investigation when a prescription drug has increased in price, over a period of twelve months, by more than fifty percent and the Superintendent believes that it is in the public interest that an investigation be made.  The OPB is tasked with conducting these investigations, which will begin by requiring the manufacturer – or other party responsible for the price increase – to file a sworn statement as to all the facts and circumstances concerning the price increase.  The OPB may also demand documents and data, examine witnesses under oath, and subpoena relevant parties.  

The OPB can call upon the expertise of the DAB and refer matters to the DAB, which will review the record, provide critical advice to DFS on issues such as whether increases in the price of the drug over time were significant and unjustified, and record those expert determinations in a report to the Superintendent.  Upon receipt of the DAB’s report, the Superintendent can hold a public hearing where the manufacturer or others can be called to answer to the public for the unjustified price hike.  

The OPB will monitor the market and complaints from the public.  Members of the public are encouraged to report a spike that they have experienced on the special reporting form which has been created on DFS’s website under “Report a Drug Spike.” The DFS website will also contain information about ongoing investigations and provide the public with access to DAB reports once they are released. 

“The diverse skills and experience of the members of this inaugural Drug Accountability Board truly represent some of the best New York State has to offer and brings together appropriately varied experiences to tackle this complex issue,” said Superintendent Lacewell.  “I want to thank the members for dedicating their time and expertise to this important effort and for their willingness to serve the people of the State of New York.”  

• Richard Weber has been appointed the Chair of the DAB.  He is the General Counsel for the New York State Department of Financial Services.  Prior to this role, he served in numerous senior public service roles at the federal, state, and city levels, including Chief of the Criminal Investigation Division at the Internal Revenue Service, Deputy Chief of the Investigation Division and Chief of Major Economic Crimes at the New York District Attorney’s Office, Chief of Asset Forfeiture and Money Laundering at the U.S. Department of Justice, and an Assistant U.S. Attorney at the U. S. Attorney’s Office for the Eastern District of New York.    
• Andrew Kaplan is the Associate Director of Pharmacy at Mount Sinai West, and oversees Pharmacy Operations in IV Admixture, Automation, and Inventory Management.  Prior to this role, he was Assistant Director of Clinical Services for Mount Sinai West. Mr. Kaplan received his Pharm. D. at St. John’s University.   
• Anna Kaltenboeck is the Senior Health Economist and Program Director for the Center of Health Policy and Outcomes and the Drug Pricing Lab at Memorial Sloan Kettering Cancer Center. Prior to this role, she was the manager for Analysis Group and IMS Consulting Group.  Ms. Kaltenboeck received her B.A. and M.S. from Tufts University and her M.B.A. from Yale University.  
• Beth R. Finkel is the State Director for AARP. Prior to this role, she was appointed as Director of Engagement for AARP New York.  Ms. Finkel received a B.S. from American University and M.S. from Yeshiva University.  
• Barbara Rogler is a Clinical Assistant Professor at the University at Buffalo and, in this role, serves at the New York Department of Health managing operations connected to Medicaid Program’s Drug Utilization Review Board.  Prior to this role, she was the Clinical Account Manager for Catamaran. Ms. Rogler received a B.S. from Albany College, an M.S. from Russell Sage College, and a Pharm. D. from Shenandoah University.    
• Gabriela Dieguez is the Principal and Consulting Actuary with the New York office of Milliman. At Milliman she concentrates her practice on health insurance issues including, pricing health plans, analyzing benefit utilization, forecasting medical trends, and performing financial projections.  Ms. Dieguez received her B.S. from the University of Buenos Aires.  
• Silpa Mandava is an Internal Medicine Specialist and Assistant Professor for the Department of Medicine at Roswell Park Cancer Institute. Prior to this role, she was the Chief Medical Resident at Buffalo, VA Hospital.  Ms. Mandava received her M.D. from University of Buffalo.  

The enabling legislation reserves two members of the DAB to be appointed at the recommendation of Legislative Leaders, one from the Speaker of the Assembly and one from the Temporary President of the Senate. 

• Honorable John T. McDonald is currently serving his fourth term in the New York State Assembly representing the 108th Assembly District, which consists of parts of Albany, Rensselaer and Saratoga Counties. He previously served as the Mayor of the City of Cohoes for 13 years, and is a practicing pharmacist and the President of Marra's Pharmacy. Assemblymember McDonald received a BS in Pharmaceutical Sciences from Albany College of Pharmacy and was awarded an Honorary Doctorate of Humanities as well.  
• Theresa Baxter is a Nurse Practitioner at SUNY Upstate University Hospital and for Helio Health Syracuse in the Center of Treatment Innovation. Prior to this role, Ms. Baxter was a Nurse Practitioner for Acute Pain Service at University Hospital in Syracuse. Ms Baxter received her B.S. in Nursing from Keuka College, her M.S. in Nursing at SUNY Upstate Medical University and recently completed post-master’s studies in mental health at SUNY Upstate Medical University. 

DFS has proposed a regulation formalizing the creation of the OPB and setting rules necessary to ensure that the proceedings of the DAB are free from conflicts of interest.  The public comment period for the regulation will run through January 11, 2021.   

Comments on the regulation or any questions may be addressed to Eamon Rock, Director of the Office of Pharmacy Benefits at [email protected] and more information can be obtained on the DFS website.    

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