Groups Debate Implications of Enrollment in Maine, Ohio Drug Discount Programs
The Maine Rx Plus program -- which is similar to Proposition 79 on the Nov. 8 special election ballot -- is used by at least 40% of eligible Maine residents, or 7% of the state's population, while the Ohio's Best Rx program -- similar to Proposition 78 -- has enrolled no more than 12% of Ohio's eligible population, or less than half of 1% of the state's residents, the Los Angeles Times reports (Girion, Los Angeles Times, 10/18).
Proposition 78 would establish a voluntary prescription drug discount plan for state residents whose annual incomes do not exceed 300% of the federal poverty level. The measure is supported by the Pharmaceutical Research and Manufacturers of America.
Proposition 79, a measure supported by Health Access California and a coalition of labor groups, would require drug makers to participate in a prescription drug discount program or face exclusion from the Medi-Cal formulary in some cases. To qualify, state residents' annual incomes could not exceed 400% of the federal poverty level. State residents who spend more than 5% of their annual income on health care also would be eligible to participate in Proposition 79's drug discount program. In addition, people could sue a pharmaceutical company if they believe it is participating in illegal pricing practices (California Healthline, 10/17).
According to the Times, Maine Rx Plus "appears to give [enrollees] better prices at the drugstore" than Ohio's Best Rx, as evidenced by a reduction by half over the past several years in participation in bus trips to Canada to purchase prescription drugs sponsored by the Maine Council of Senior Citizens.
Maine has not used a "hammer" -- a provision that would let the state restrict drug makers' access to the state Medicaid program in some instances -- against drug companies, but it has used the program to encourage drug companies to expand their sales by participating voluntarily.
Kathryn Duke, director of the Oakland-based Public Health Institute's Medicine for People in Need project, said, "It's pretty clear that a hammer brings better prices than a voluntary program."
Julie Corcoran, deputy vice president for PhRMA, said Proposition 79 was "fraught with some legal infirmities and regulatory problems ... that will, in essence, preclude it from being implemented."
A legal challenge to the Maine program was thrown out of a local court after it had been sent back by the U.S. Supreme Court. However, the legal challenge delayed implementation of the program for three years (Los Angeles Times, 10/18).
The pharmaceutical industry has become among the "top campaign spenders in history" over the competition between Proposition 78 and Proposition 79, having spent $80 million so far, the San Diego Union-Tribune reports.
Jan Faiks, vice president of government affairs for PhRMA, said, "We want [Proposition 78] to be a model for the rest of the country."
However, opponents have said the industry is actually "bombard[ing] the airwaves with ads that confuse voters so much that they reject both dueling drug measures," the Union-Tribune reports.
Anthony Wright, a spokesperson for Proposition 79, said, "The drug companies don't care about Proposition 78. Their real effort is to stop Proposition 79" (Ainsworth, San Diego Union-Tribune, 10/18).
Summaries of opinion pieces addressing Propositions 78 and 79 appear below.
- William Remak, San Francisco Chronicle: Proposition 79 would "jeopardiz[e] the health of the poor and the catastrophically ill in order to provide prescription-drug discounts to middle-class Californians," Remak, chair of the California Hepatitis C Task Force, writes in a Chronicle opinion piece. He adds that "the federal government is highly unlikely to approve such a scheme," whereas Proposition 78 "would offer immediate help and would not require federal approval" (Remak, San Francisco Chronicle, 10/18).
- Earl Lui, San Francisco Chronicle: Proposition 79 would reduce prescription bills for "millions" of California residents by "50% or more" and would "buil[d] on the success" of negotiations that are already made by the state with pharmaceutical companies for Medi-Cal beneficiaries, Lui, an attorney for Consumer's Union, writes in a Chronicle opinion piece. The Medi-Cal discounts have saved taxpayers $5 billion over the last 10 years, whereas a previous voluntary approach for drug discounts -- called the Golden Bear State Pharmacy program -- was ended by Gov. Arnold Schwarzenegger (R) after "[o]nly 14 drug companies offered to provide discounts," Lui writes (Lui, San Francisco Chronicle, 10/18).
- La Donna White, Sacramento Bee: "Because Proposition 79 would hold Medi-Cal patients hostage should drug manufacturers not participate in the program, it would need federal approval, which it is extremely unlikely to achieve," White, president of the Capital Medical Society, writes in a Bee opinion piece. White concludes that Proposition 78 "can work and truly help people access the prescription medicines they need" (White, Sacramento Bee, 10/18).
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