Bill > A02126

This bill establishes a three-year pilot program to study and control the cost of prescription drugs by setting a "referenced rate," which is the maximum price allowed for certain drugs. The program is designed to address findings that New Yorkers pay significantly more for prescription drugs than Canadians, leading to negative impacts on health, economic well-being, and overall healthcare costs. The bill defines key terms such as "prescription drug," "wholesale acquisition cost" (the manufacturer's price before discounts), "state entity" (government agencies purchasing drugs for state-funded healthcare, excluding Medicaid), "health plan," and "ERISA plan" (plans qualified under the Employee Retirement Income Security Act of 1974). A "participating ERISA plan" is one that chooses to be subject to the program's rules. The "referenced rate" will be determined by the superintendent by comparing the wholesale acquisition cost to prices in Canada, specifically from Ontario, Quebec, British Columbia, and Alberta drug formularies, or the Canadian government's ceiling price if a drug isn't listed. It will be illegal for state entities and health plans to pay more than this referenced rate for "referenced drugs" (the ten most expensive drugs identified by the state) and for pharmacies to purchase them at a higher cost for these entities. ERISA plans can opt into the program. The bill also prohibits manufacturers or distributors from withdrawing drugs from the state to avoid the program's impact and requires them to negotiate prices in good faith, with penalties for violations. Savings generated by the program must be used to benefit purchasers and consumers of healthcare, and reports on savings and program effectiveness will be submitted to state officials.

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https://www.nysenate.gov/legislation/bills/2025/A2126