Investigating Drug Price Spikes
Part XX of Chapter 56 of the Laws of 2020 authorizes the Department of Financial Services to investigate significant spikes in prescription drug prices and to require drug manufacturers, or whomever is responsible for the price increase, to show a reasonable justification for sudden increases. The Department has created the Office of Pharmacy Benefits (OPB) to carry out these investigations and to monitor drug pricing issues.
Part XX of Chapter 56 also creates a 9-member Drug Accountability Board, which is a panel of experts appointed by the Superintendent to aid in an investigation of a drug spike. It is charged with making determinations about the spike and issuing a report to the Superintendent on those determinations.
- Ascor (ascorbic acid) 25,000 mg/50 mL bulk vial
- Budesonide 0.5 mg/2 mL inhalation (60 mL).
- Dexonto (dexamethasone) 5 mL vial of a 0.4% solution
- Mytesi (crofelemer) 125 mg delayed release tablet, 60s
- Duramorph (morphine sulfate) 1 mg/1 ml (10 mL 10s)
- Chloroquine phosphate 250 mg tablets
Reports on completed investigations will be posted to our Reports & Publications section as they are released.
Drug Accountability Board
The Drug Accountability Board (DAB) is comprised of consumer representatives, medical professionals, health economists and other experts in the pharmacy benefit pricing field. The DAB is responsible for determining, among other things:
- a drug’s impact on premium costs for commercial insurance in New York
- a drug’s affordability and value to the public
- whether increases in the price of the drug over time are significant and unjustified
- whether the drug may be priced disproportionately to its therapeutic benefits
Deputy Superintendent for Health
New York State Department of Financial Services
John began working at the Department of Financial Services in July 2007 (then called the NYS Insurance Department). He has held various positions, most recently as Deputy Superintendent for Health. In that capacity, John oversees all aspects of the Health Bureau, including premium rate review, legislative and regulatory matters, solvency and financial oversight, policy form approval, and market conduct examinations.
Prior to working with the Insurance Department, John was an Assistant Attorney General in the Health Care Bureau of the New York State Office of Attorney General. There, he worked on cases involving deceptive business practices in the health care industry, including pharmacy benefit manager practices, health plan billing practices and consumer protection matters.
John has worked as counsel to New York State Senator Roy Goodman, worked in private practice in Albany, NY, and held a judicial clerkship in the Appellate Division, Third Department. John graduated from Albany Law School in 1995, where he was Editor-in-Chief of the Albany Law Review.
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. Ms. Baxter was appointed at the recommendation of the Temporary President of the Senate.
Gabriela Dieguez is a principal and consulting actuary with the New York office of Milliman. She joined the firm in 2005. Gabriela has provided actuarial and consulting services to a wide range of clients, including commercial insurers, Medicare Advantage organizations, pharmaceutical companies, Blue Cross/Blue Shield plans, HMOs, and healthcare providers. She has extensive experience in pricing, valuation, analyzing benefit utilization, forecasting trends, and performing claims analytics for particular disease states. Gabriela has advised life science companies and other clients on actuarial topics related to health care reform, Medicare Advantage and Part D, risk sharing contracting, and payer economic issues.
As State Director, Beth R. Finkel leads the day-to-day operations of AARP New York.
During her tenure as State Director, AARP’s efforts on behalf of its 2.5 million New York members and their families have led to historic NYS reforms including passage of the Secure Choice Savings Program, Care Act, Assisted Living protections, Anti Predatory Lending, Paid Family Leave and Affordable Housing and Right to Counsel in NYC legislation, numerous bills on Kincare and – since the onset of the coronavirus pandemic – groundbreaking state legislation to improve nursing home conditions, ban utility shutoffs, allow for universal absentee voting, and expand access to on-line food ordering and delivery through the SNAP program.
Prior to her appointment as State Director, Beth was the Director of Engagement for AARP New York. In her role, Beth specialized in programming and advocacy for older New Yorkers around hunger, caregiving, grandparents raising grandchildren, multicultural outreach, livable communities, financial security, ageism and long-term care.
Through her years at AARP New York, she led and developed the statewide Kincare Coalition and New York’s Older Adults Hunger Stakeholders Coalition. She convened the first Older Adults Hunger Summit to find solutions to barriers to food insecurity and co-created the NYS Medicare Savings Program Taskforce. Beth represented AARP New York on the Governor’s SMART (Saving More to Achieve Richer Tomorrows) Commission, which helped develop the Secure Choice Savings Program, and she serves on The NYS Food Policy Workgroup, The NYS Department of Financial Services Consumer Protection Taskforce and the NYC Age Friendly Commission.
A native New Yorker, Beth holds a Masters of Social Work from Yeshiva University in Community Organizing and a Bachelor of Science from American University in Business Administration. She and her husband live in Manhattan.
Anna Kaltenboeck, MS is a senior health economist and the program director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center. Her work focuses on the development and application of value-based pricing methods, as well as policies that foster rational and sustainable drug pricing.
Prior to joining MSKCC, Ms. Kaltenboeck spent 10 years consulting on health economics and outcomes research, as well as pricing and market access for pharmaceutical and diagnostic products. An alumna of both Analysis Group and IMS Consulting Group, the scope of her work spans the US, EU5, and emerging economies. She has published numerous articles in peer-reviewed scientific and policy journals. Ms. Kaltenboeck holds bachelor’s and master’s degrees in economics from Tufts University.
Andrew Kaplan received his Doctor of Pharmacy from St. John’s University in 2011 and went on to complete his PGY1 Pharmacy residency at Stony Brook University Hospital in Long Island and his PGY2 Health System Pharmacy Administration residency at the VA in Madison, Wisconsin. After completing residency training, Dr. Kaplan became the Pharmacy Supervisor at St. Catherine of Siena Medical Center in Smithtown. He then moved to New York City and became the Assistant Director of Clinical Services for Mount Sinai West, overseeing Critical Care, Infectious Disease, Emergency Medicine, Transitions of Care and Internal Medicine.
He is currently the Associate Director of Pharmacy, now additionally overseeing Pharmacy Operations in IV Admixture, Automation, and Inventory Management. Dr. Kaplan currently serves as the Vice President of Public Policy for the New York State Council of Health-system Pharmacists, overseeing legislative and regulatory affairs. He previously served as President of the Long Island Society of Health-system Pharmacists.
Dr. Mandava is licensed Physician in NY state and currently works as Assistant Professor, Department of Medicine at Roswell Park cancer Institute, Buffalo NY. She completed her Internal Medicine Residency training at University of Buffalo, 2014 and worked as Chief Medical Resident at Buffalo, VA Hospital.
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. Assemblymember McDonald was appointed at the recommendation of the Speaker of the Assembly.
Dr. Barbara Rogler is currently a Clinical Assistant Professor at the University at Buffalo School (UB) of Pharmacy and Pharmaceutical Sciences. She is a licensed Pharmacist, registered to practice in New York State. Her current primary responsibility is as the liaison between the New York State Department of Health (DOH), Office of Health Insurance Programs (OHIP), and the State University of New York (SUNY) Collaborative. Dr. Rogler has also worked in several different healthcare continuum positions spanning a wide variety of leadership roles. Her leadership roles have included clinical, educational, legislative, and managerial as a policymaker and advisor on both the state and national levels. Dr. Rogler holds a Bachelor of Science (BS) in Pharmacy, a Master of Science (MS) in Health Service Administration, and a Doctor of Pharmacy (PharmD).
Related Laws and Regulations
Reporting a Drug Price Spike
To report a drug price spike
Use the DFS Portal to report a dramatic increase in the cost of a drug or pharmacy benefit that you use. You can also check the status of a complaint, or add information to an existing complaint. Be aware that we may share a copy of your complaint with the company or individual you are complaining about.
To get started please visit our secure Portal: