CRITICAL VOTE
Issue 2 puts Ohio voters in national spotligh again, seekin chan to state’ comple drug-pricing system.
Across political lines, Americans in poll after poll say prescription drugs cost too much, and stories abound about patients cutting pills in half or making the difficult choice between their medications and putting food on the table.
But while people may agree on the problem, what to do a bouti t has thrust Ohi oansint he middle of a big-dollar battleground pitting big pharma against a group that says it has a plan to lower prescription drug prices.
Some are arguing that the provisions outlined in the Issue 2 ballot measure could do just the opposite.
The two sides are already going head-tohead in media ads that will continue over the next month, creating a confusing picture for voters to follow.
And there’s not much time to sort through the proposal. The election is Nov. 7 and early voting begins Oct. 11.
To provide more clarity on what’s in the measure, we break down the arguments from both sides inside today’s paper on
Q: Who is backing for and against? Who funds those PACs?
A: The group supporting the measure is called Ohio Taxpayers for Lower Drug Prices.
Its campaign is almost entirely funded by the AIDS Healthcare Foundation, a California non-profit that bills itself as the largest provider of HIV/AIDS medical care in the U.S. Its founder and president is Michael Weinstein who is seen by some as a controversial figure, but who is also credited with saving the AIDS Taskforce of Greater Cleveland from collapse.
Endorsements of the Yes campaign have come mostly from individuals including politicians, doctors, veterans and concerned citizens. The campaign also has the endorsement of National Nurses United.
The group opposed to Issue 2 is called Ohioans Against the Deceptive Rx Ballot Issue.
The campaign is entirely funded by major drug manufacturers through the Phar- maceutical Research and Manufacturers of America, or PhRMA, a drug industry trade group. There are 37 companies listed as members of PhRMA on its website.
The No campaign is endorsed by more than 70 organizations representing doctors, nurses, veterans, pharmacists, business, labor and retirees.
Q: Which advertisement is correct on Issue 2? Both say they will lower drug costs. I want to lower drug
costs so should I vote yes or no?
A: The answer to this question really depends on where in the supply chain you are looking at the “cost” of drugs.
Issue 2, if passed, would only lower what Medicaid and other state-run health plans pay for drugs — and therefore would reduce the amount of tax dollars spent on prescription drugs.
It would not directly impact how much drug manufacturers charge for the drug from the outset. It wouldn’t change how much pharmacies pay to stock the drug, or how much custom- ers on various health plans spend out-of-pocket.
And it wouldn’t have any direct impact for the major- ity of Ohioans who are on private or employer insurance or on Medicare, which is a federal program.
That being said, the two sides each say there would be collateral consequences that could cause drug prices for everyone to go up or down.
Voting no, according to the No campaign, will not lower drug prices. It would simply maintain the current system and status quo on drug pric- ing. But the campaign says that a Yes vote could actually increase drug prices for some people. This could happen in a few ways. Drug compa- nies could simply increase the list price of drugs as they have been doing, because Issue 2 doesn’t stop them from charging whatever they want. And if the average price goes up, so too does the VA price. Drug companies could also stop giving out the addi- tional discounts they currently give to the VA and Medicaid. And for some health plans, like the state retirement programs, the pressure to get state costs down to the VA level could result in cost shifting in which the state charges the retirees a larger share of their prescription costs.
According to the Yes campaign, those increases are all just scare tactics being used by the pharmaceutical companies funding the other side. They say that voting yes for Issue 2 will cause not only the state programs to pay lower prices for drugs, but will lead to others like Medicare and private insurance plans to demand those same low prices, eventually bringing down costs across the market.
Q: If the opposition claims it is impossible to know VA prices, how can they say that people are already paying c lose to those prices in the first place?
A: This claim is based on the fact that federal law dictates a mandatory discount for both the VA and Medicaid.
The VA receives a 24 per- cent mandatory discount and then gets additional discounts off of that. Medicaid must receive a 23.1 percent mandatory discount and then negotiates additional discounts off of that.
So it’s unknown what the ultimate lowest price is that either ends up paying, but we know the initial discounts are pretty close. Medicaid and other state plans also have distribution costs that the VA doesn’t have.