NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A8533B
SPONSOR: Joyner
 
TITLE OF BILL:
An act to amend the public health law, in relation to drug assistance
demonstration and emergency prescriptions
 
PURPOSE:
To ensure that those in need of insulin and Other life sustaining medi-
cations can access them through a drug an assistance demonstration
program and emergency refills for expired prescriptions
 
SUMMARY OF PROVISIONS:
Section 1 amends Public Health Law to add a new section 279-a directing
the Department of Health to develop a demonstration program to ensure
access to insulin and other life sustaining, maintenance prescription
medications for patient who meet certain medical criteria, are uninsured
or underinsured and are ineligible for Medicaid or other publicly funded
health coverage and meet certain financial criteria. The Department is
directed to report to the Governor and Legislature on its findings no
later than three months after enactment.
This section also creates a new section 279-b to allow a health care
provider to issue non-patient specific standing orders for a pharmacist
to dispense emergency prescriptions to refills expired prescriptions for
any types of insulin, or other medications identified by the commission-
er, for an individual whose prescription has expired within the last
twelve months and is unable to get authorization for a refill. Pharma-
cists are allowed to dispense emergency refill of insulins, related
supplies or other life sustaining, maintenance prescription medications
identified by the commissioner under this section.
Section 2 provides an effective date.
 
JUSTIFICATION:
In recent years, there has been a dramatic rise in prices for insulin, a
lifesaving prescription medication that many people with diabetes must
take to regulate their glucose levels. According to the American
Diabetes Association, about 7.4 million Americans rely on insulin and
approximately 2 million of those are New York residents. The cost of the
four most popular types of insulin have tripled over the last decade,
and the out of pocket costs have doubled. These price hikes are report-
edly not attributable to increases in usage or new products that are
more innovative. They not only affect those who are uninsured and unde-
rinsured, they also affect those with health insurance who experience
exorbitant co-pays. The rising costs of insulin have dramatic effects on
patients. Studies have shown that 1 in 4 patients use less insulin than
prescribed in order to ration it. Rationing is very dangerous and can
lead to deadly outcomes for those who depend on insulin. As a result of
the skyrocketing insulin prices, congress initiated public hearings in
2019 to investigate what can be done nationally to control prices and
several states are taking action to make sure patients who depend on
insulin for their very survival can get it. Some consumers have report-
edly begun travelling to Canada to secure more affordable insulin.
States are also taking action.
As part of the 2020-21 State budget New York joined with other states
that have capped cost sharing for insulin and adopted a limit on copay-
ments of $100 for a thirty-day supply of each insulin. This bill was
amended to remove the cost sharing limits.
Several states have also enacted laws to ensure that when a prescription
for insulin has expired, a pharmacist has the ability to provide an
emergency refill, as this bill does.
This legislation also directs the Department of Health to develop a Drug
Assistance Demonstration Program to assist patients who do not have
insurance, are not eligible for Medicaid or other publicly funded health
care coverage, or are deemed eligible by the Commissioner, to be able to
access life sustaining medications such as insulin. It directs the
Department to report to the Governor and the legislature on the options
available to establish such a program and the resultant state costs to
support such a program. Extreme adverse effects which result from lack
of insulin are very costly to our health care system. Reducing the
instances of these adverse affects that insulin dependent individuals
experience by creating a drug assistance program will not only reduce
pain, suffering and death but help to lower overall health care
expenses. ill
New York has a long history of being ahead of the nation in providing
health care assistance to its resident's. In the 1980's, in response to
the AIDS epidemic, New York was one of the first states to create a
program to provide AIDS/HIV medications to. low-income patients. New
York should look at this groundbreaking program as a model to ensure New
Yorkers who depend on other life sustaining medications, like insulin,
also have access to assistance, especially in light of the skyrocketing
costs.
This legislation provides a multi-pronged approach to addressing access
to insulin for patients in New York who rely upon it for their very
existence.
 
LEGISLATIVE HISTORY:
New bill.
 
FISCAL IMPLICATIONS:
None.
 
EFFECTIVE DATE:
Immediately
STATE OF NEW YORK
________________________________________________________________________
8533--B
2019-2020 Regular Sessions
IN ASSEMBLY
August 14, 2019
___________
Introduced by M. of A. JOYNER, O'DONNELL, LENTOL, WILLIAMS, REYES,
SEAWRIGHT, SIMON, HEVESI, FERNANDEZ, DINOWITZ, BURKE, MOSLEY, DICKENS,
L. ROSENTHAL, ARROYO, FALL, SMITH, McDONOUGH, MONTESANO, ORTIZ,
COLTON, THIELE, JAFFEE, GUNTHER, CRUZ, COOK, MAGNARELLI, WALKER,
CARROLL, DE LA ROSA, BLAKE, GRIFFIN, D'URSO, BRONSON, DenDEKKER, BENE-
DETTO, SAYEGH, JACOBSON, STIRPE, MANKTELOW, GOTTFRIED, BARRON, OTIS,
TAYLOR, SIMOTAS, D. ROSENTHAL, NIOU, GLICK, WOERNER, LAVINE, ABINANTI,
M. G. MILLER, AUBRY, BUTTENSCHON -- Multi-Sponsored by -- M. of A.
BUCHWALD, TAGUE -- read once and referred to the Committee on Health
-- recommitted to the Committee on Health in accordance with Assembly
Rule 3, sec. 2 -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee -- recommitted
to the Committee on Health in accordance with Assembly Rule 3, sec. 2
-- committee discharged, bill amended, ordered reprinted as amended
and recommitted to said committee
AN ACT to amend the public health law, in relation to drug assistance
demonstration and emergency prescriptions
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 two new sections
2 279-a and 279-b to read as follows:
3 § 279-a. Drug assistance demonstration program. 1. The commissioner
4 shall develop a demonstration program (the "program") to provide access
5 to insulin and other life sustaining maintenance prescription drugs
6 identified by the commissioner for residents of the state who are with-
7 out health coverage, are ineligible for Medicaid or other publicly fund-
8 ed health coverage, or are otherwise determined to be eligible by the
9 commissioner and depend upon such medication for their survival. In
10 developing the program the commissioner shall:
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD13323-12-0
A. 8533--B 2
1 (a) consider modeling the program on the state's HIV/AIDS drug assist-
2 ance program providing access to eligible individuals at certain income
3 thresholds above the federal poverty level; and
4 (b) engage with pharmaceutical manufacturers to explore a public
5 private partnership to bring affordable drugs through the program to
6 eligible individuals.
7 2. The commissioner shall report to the governor, the temporary presi-
8 dent of the senate, the speaker of the assembly, and the chairs of the
9 senate and assembly health committees on the available options to estab-
10 lish the program, various cost sharing models for eligible participants
11 and the related costs to the state associated with implementing the
12 program. The report shall be a public document posted on the depart-
13 ment's website. The report shall be issued no later than three months
14 after the effective date of this section.
15 § 279-b. Emergency prescriptions. 1. A health care practitioner who is
16 authorized to prescribe a drug may issue a non-patient-specific
17 prescription for the drug to a pharmacist to dispense an emergency
18 refill for an expired prescription for the drug, under subdivision two
19 of this section.
20 2. A pharmacist may dispense insulin and related supplies, or other
21 life sustaining maintenance prescription drug identified by the commis-
22 sioner, through a non-patient-specific prescription, to an individual
23 who has had a valid prescription for the drug during the prior twelve
24 month period which has since expired, on an emergency basis provided the
25 pharmacist:
26 (a) first attempts to obtain an authorization from the prescriber of
27 the patient-specific prescription and cannot obtain the authorization,
28 and the prescriber does not object to dispensing to the patient under
29 the non-patient-specific prescription;
30 (b) believes that, in the pharmacist's professional judgment, the
31 interruption of the therapy reasonably might produce an undesirable
32 health consequence detrimental to the patient's welfare or cause phys-
33 ical or mental discomfort;
34 (c) provides refill of the prescription and the quantity of that
35 refill is in conformity with the directions for use under the patient-
36 specific prescription, but limited to an amount not to exceed a thirty-
37 day emergency supply; and
38 (d) notifies, within seventy-two hours of dispensing the refill or
39 refills, the original prescriber that an emergency prescription has been
40 dispensed.
41 § 2. This act shall take effect immediately.