by Samuel V. Butcher, Esq.
When Ohioans vote this November they will be asked to cast their ballot for or against a healthcare initiative that, if enacted, would create a new state statute forbidding the State of Ohio, through its various state agencies and programs, from paying more for prescription drugs than the lowest price paid for the same drug by the U.S. Department of Veterans Affairs. Sounds reasonable on its face and maybe even like a pretty good idea. A closer look at the proposal however, raises serious questions about whether the initiative, if passed, would (to stick with the pharmacy theme) create adverse reactions and side effects greater than the ill it seeks to remedy.
The title of the Act is “The Ohio Drug Price Relief Act.” A summary and full text of the proposal from the Ohio Secretary of State’s Office can be found at (https://www.sos.state.oh.us/sos/upload/ballotboard/2015/2015-07-21-petition.pdf). Ohio Taxpayers for Lower Drug Prices is leading the campaign in support of the initiative. The primary organization in support of the campaign is the AIDS Healthcare Foundation and its president, activist, Michael Weinstein. The opposition campaign, Ohioans Against the Deceptive Rx Ballot Issue, counts over thirty organizations among its supporters. They include veterans groups, mental health agencies, the Ohio Chamber of Commerce, the Pharmaceutical Research and Manufacturers of America (PhRMA) and, most notably in this author’s opinion, the Ohio Pharmacists Association (OPA).
I practiced pharmacy full time before completing law school and devoting my professional time exclusively to the practice of law. I’m proud to say that Pharmacists typically come in close to the top in Gallup’s Honesty and Ethics in Professions polling, and ranked second only to Nurses, in the poll conducted in December 2016. I agree with what the OPA refers to as a “broken system” of prescription drug pricing that surely needs to be fixed. I concur however, with their conclusion that the Ohio Drug Price Relief Act (“the Act”) is not the right cure.
The proposed statute could result in major price increases for millions of Ohioans. The OPA has opined that it could have serious negative consequences for employers, veterans, and patients, among others. That’s why OPA is working hard to defeat the measure. Noteworthy also, is the fact that the Ohio Nurses Association and the Ohio State Medical Association also oppose the Act.
Here are some of the potential “side effects” of the proposal. Pharmaceutical companies currently give steep rebates and discounts to the VA program. If those rates are used as a benchmark for other programs, the pharmaceutical companies could end the discounts for the VA, and charge everyone higher prices. Alternatively, since there is no requirement that pharmaceutical companies charge the same prices to all, if the government and VA were to receive all the major discounts, the prices for everyone else could be raised to offset those losses. That’s my idea of an “adverse reaction” to what OPA Executive Director, Ernest Boyd, has dubbed an ill-conceived, poorly crafted, and unworkable proposal. There is also a real possibility that the initiative could restrict access to medication if, as a result of the enactment of the proposal, the VA removes certain drugs from its formulary.
The Ohio Drug Price Relief Act has been compared to California Proposition 61, Drug Price Standards (2016), a nearly identical measure that was defeated on November 8, 2016. Jeremy Pelzer reported in an article on Cleveland.com, that more than $128 million was spent on that ballot measure in California. Thus, he reported, the Ohio initiative could end up being the most expensive ballot-issue campaign in Ohio history. Expect to see many more commercials funded by both campaigns as the election draws near, and a lot more hubbub. Hopefully, Ohioans will look beyond the ads to the real consequences that could result from passage of the Act, and defeat the measure as did their golden state counterparts.