Sunday, May 25, 2003

Pressure on for drug discounts

It's time to talk, says Ohio GOP

By Debra Jasper
Cincinnati Enquirer Bureau

COLUMBUS - After long opposing a plan to give 2.2 million uninsured Ohioans deep discounts on prescription drugs, Republican leaders switched direction last week and are now considering it.

"We know the position of the public: they want relief from rising drug costs," said House Speaker Larry Householder, R-Glenford. "It's time to sit down and talk, that's for sure."

Householder and other Republican leaders changed their stance after the U.S. Supreme Court ruled May 19 in favor of a Maine plan to lower drug prices by allowing the state to negotiate directly with drug companies on behalf of the uninsured and working poor.

Democrats in the Ohio House and Senate have similar proposals that they say could cut prescription drug prices by as much as 40 percent to 50 percent. Until now, majority Republicans have balked at the measures, saying they could get tied up in expensive court battles and might be unconsitutional.

"The court removed the obstacles and now Republicans have to look at themselves and say, 'We're out of excuses, we have to do this,' " said Robert Hagan, D-Youngstown, the sponsor of a drug-discount bill in the Senate.

"People are really struggling to pay their prescription drug costs and the only way we're going to curtail the gouging of the public by the pharmaceutical industry is to pass this bill as soon as possible."

House Democrats say action can't come quick enough. "All we're trying to do is get the state to leverage its negotiating power so people without insurance won't have to pay so much," said state Rep. Dale Miller, D-Cleveland, who is sponsoring a similar drug-discount plan in the House. "We're trying to get a hearing going over here."

Senate President Doug White, R-Manchester, said Republican senators are also starting to talk favorably about the bill, but he thinks it will probably be phased in.

"I would like to see us start something on this very quickly," White said. "We might not be able to finalize anything (next week) but we can take another step and give citizens some confidence that, ultimately, we'll get to a bona fide, helpful program."

Ohio isn't alone in wrestling with what to do about prescription drug costs, which officials say are increasing at rates of 15 percent to 20 percent a year for Medicaid, the health care program for the poor. At least 18 states are considering bills this year to create drug-discount programs similar to the Maine program, called Maine Rx.

Under that program, fiercely opposed by the pharmaceutical industry, Maine offered the same drug discounts it got for Medicaid recipents to the working poor, disabled and uninsured - even if they weren't poor enough to qualify for Medicaid.

The state built in strong incentives for drug companies to give the discounts. If they didn't, their drugs could be put on a "prior authorization," meaning doctors had to go through a complicated procedure and get state approval before prescribing those drugs - a process many try to avoid.

Democrats and other advocates have grown increasingly frustrated by the Republicans' refusal to adopt a drug discount program in Ohio modeled after the one in Maine.

The program was debated during the governor's race last year. And last December, a group called the Coalition for Affordable Prescription Drugs filed petitions with 140,000 signatures to try to force the legislature to either act on the plan or allow it to go on the ballot.

The coalition, formed in 2002 by 19 non-profit organizations, including the United Way, the Ohio AARP and the Ohio AFL-CIO, is pushing legislation called the Ohio Prescription Drug Fair Pricing Act. If passed, it would offer discounts to the 2.2 million Ohioans who lack prescription drug coverage or who are underinsured, including the working poor and about 1 million seniors.

Dale Butland, spokesman for the coalition, said Pharmaceutical Research and Manufacturers of America, or PhRMA, a Washington-based group representing drug companies, has challenged the signatures in 41 of 88 counties. He said now that the U.S. Supreme Court has acted, Ohio lawmakers shouldn't wait for the signatures to be validated.

"The legislature should get off its duff and pass this legislation. If it doesn't, I don't like to think that lawmakers are doing PhRMA's bidding, but, frankly, it's getting more suspicious all the time," Butland said.

White said the court decision on Maine's plan "is still very fresh" and needs to be reviewed before lawmakers vote on the issue. He fears that giving drug discounts to millions of people without insurance could cost insured people more money because drug companies will pass along the costs.

"There are no free lunches," White said. "You can't put drug companies in a position where they have to absorb all the costs. It gets worked back into the economy somehow."

Jenny Camper, spokesperson for PhRMA, said the industry opposes these discount programs because they establish price controls and limit some people's access to medication. If a drug company refused to negotiate prices, for example, drugs might not be available to Medicaid recipients.

"A program that holds Medicaid patients hostage is very much a concern," she said.

Camper added that companies take huge risks when researching drugs to bring to market and need time to recoup those costs. "It's easy to say drugs cost too much. But there is a reason for that. It costs $800 million to bring some drugs from conception to market. And that doesn't count the rabbit trails that lead nowhere."

Butland dismisses those arguments, saying pharmaceutical companies are among the most profitable in the world. "Drug companies spend 2.5 times more money on advertising, public relations and marketing than they do on research, so that's a crock," Butland said.

He said companies oppose drug discounts for one reason. "Greed, plain and simple."

Amid the debate over the Maine plan, Gov. Bob Taft is moving forward with his own plan to lower prescription drug costs for Ohioans over 60. During his re-election campaign, Taft said he would unveil a prescription card in January that would give 10 percent to 30 percent discounts to 2 million seniors.

But he has had trouble delivering on that promise. Pfizer, the nation's largest drug maker, has declined to participate in the program. State lawmakers have proposed cutting $170,000 from the program's administrative budget. The card's release is five months behind schedule. And officials now say because some people already get drug discounts, the number of people who will actually benefit from the Golden Buckeye Card is now closer to 600,000.

Despite the problems, Taft's spokeswoman, Ann Husted, said the Golden Buckeye Card program will be introduced in 30 days and Taft is satisfied with the plan.

"It allows seniors to participate immediately," she said.

Husted added that the governor hasn't had a chance to review the Maine decision. "We've started with seniors and now we'll explore where to go next," she said. "We'll look at all our options."

Butland says the Golden Buckeye Card is "simply inadequate" and noted that about half of the 2.2 million Ohioans without insurance aren't over 60 and don't qualify for the Golden Buckeye Card.

"Our bill would give people discounts of 30 to 50 percent," he said. "Now that's real relief."

Republican leaders, too, agree that any drug discount program that passes muster in Ohio should include more people.

"We want to make sure anything we do is good for Ohioans, not just seniors, but Ohioans as a whole," Householder said. "One of the holdups for me was the Maine case. Now that we have a clearer picture of where the court is, it's time to talk about how we can help the people in Ohio."


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