PhRMA, White House File Separate Supreme Court Briefs in Maine Rx Case
The Pharmaceutical Research and Manufacturers of America and the Bush administration on Friday filed separate Supreme Court briefs objecting to Maine Rx, the state's preferred drug program meant to limit the rising costs of prescription medications, the Washington Post reports (Goldstein, Washington Post, 9/22). Under the program, which was enacted by the state Legislature in 2000 but has not taken effect, Maine would negotiate with drug makers for discounts similar to those given to the Medicaid program. The state would use the savings to reimburse pharmacies for giving discounts to customers who lack drug coverage. State officials estimate eligible residents would save 10% to 30% on prescription drug costs under the program. In an effort to encourage drug company participation, the program includes a provision under which doctors would have to receive prior approval from a patient's health plan administrator to prescribe medications from companies that are not part of the program. In 2000, PhRMA filed a lawsuit against Maine Rx, arguing that it was not authorized by federal Medicaid law and that it was a "burden on interstate commerce." Initially, a federal district court in Maine ruled in favor of PhRMA, but in May 2001 the 1st U.S. Circuit Court of Appeals in Boston overturned the decision and said the program could go forward. On May 31, the Bush administration asked the Supreme Court to reject PhRMA's appeal, but in June the Court agreed to hear the case, PhRMA v. Concannon (California Healthline, 7/1).
In its brief, PhRMA contends that Maine Rx violates Medicaid law by making it more difficult for beneficiaries to obtain certain medications. "In effect, Maine is holding Medicaid patients' prescription drug benefits hostage to the state's fundraising efforts on behalf of others outside the Medicaid program," the brief states. PhRMA also argues the program violates the Constitution's interstate commerce provisions, which prohibit a state from regulating businesses outside its borders. Under Maine Rx, rebates would be extracted from out-of-state drug companies that do not conduct business directly with the state, but rather deal with wholesalers within the state, the brief states. In a separate brief filed Friday, the Department of Justice contends Maine Rx is illegal for a "much more limited reason" than PhRMA does, the Post reports. In its brief, the Justice Department said the program is illegal because it is not "specifically targeted to people who are poor or elderly, or who have a different need for help in paying for medicine," the Post reports. However, the White House added that despite its objections to Maine's program, it has encouraged states to continue experimenting with ways to lower prescription drug prices. "Nobody should say we are supporting PhRMA over Maine," an unnamed administration spokesperson said, adding that HHS last week encouraged states to submit proposals for increasing access to prescription drugs for low-income residents who do not qualify for Medicaid (Washington Post, 9/22).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.