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Crosscurrents

Is Prop 61 the answer to rising drug prices?

"No on Prop 61" commercials feature veterans like Lamont Duncan who oppose the ballot measure. "Yes on Prop 61" billboards have popped up all over the Bay Area.

Maybe you’ve seen the billboards for Prop 61, with AARP and the California Nurses Association urging you to “Vote Yes for Lower Drug Prices.” Or the scary TV commercials warning you to vote no on Prop 61, arguing that drug prices will go up if it’s passed.

Prop 61 is the “California Drug Price Relief Act.” It’s shaping up to be one of the most hotly contested -- and expensive -- state measures on the ballot.

The truth is Prop 61 won’t lower drug prices for everyone. It would only affect a few state programs. And Big Pharma is threatening to raise drug prices if the measure is passed.

Here’s how it would work

Prop 61 would prevent the state from paying more for prescription drugs than the Department of Veterans Affairs pays. The VA is being used as a bar because they typically get some of the biggest drug discounts in the country.

Basically, the state is looking at the VA and saying, “We’d like those discounts too, please!”

If passed, the bill would only apply to programs where the state directly purchases or is the “ultimate buyer” for medications. This includes the fee-for-service part of Medi-Cal, the state’s low-income health insurance program. It would also apply to state prisons and CalPERS, the public employees' retirement system. All in all, these programs cover about 5 million Californians.

It won’t affect people with private insurance, Medicare, or people enrolled in Covered California AKA “Obamacare”.

Who is for it and who is against it

The AIDS Healthcare Foundation (AHF) is the main backer of Prop 61. They’ve raised nine million dollars so far in support of it.

AHF runs pharmacies across the country and is well-known in the Bay Area for their “Out of the Closet” thrift stores. They’re also known for being controversial. They made waves in the AIDS community in 2014 when they came out against PreP, an HIV prevention treatment.

Jessie Brooks, an Oakland resident and advocate for the AIDS Healthcare Foundation says he's proud that the AIDS Healthcare Foundation is jump-starting the conversation on drug price reform.

“I feel like if it happens in California it will be a conversation all across the nation,” adds Brooks.

AARP and the California Nurses Associationalso support Prop 61.  Bernie Sanders has been campaigning for it too. Supporters like Jessie Brooks say that the measure is an important first step in addressing rising drugs costs across the country.

“We see every day in the news how drug prices are affecting people, like the EpiPen,” Brooks says. “Just because they saw that people needed it, they raised the prices and that’s terrible.”

Not surprisingly, drug companies have raised 86 million dollars so far defeat to Prop 61.And they’re threatening to increase the VA’s drug prices if the proposition passes. That’s turned a lot of groups against the measure.

Some veterans groups are opposed to Prop 61. So is the California Medical Association, a professional group for doctors. Many doctors support lower drug prices but worry this particular measure will backfire.

Oakland pediatrician and allergist Dr. Michael Lenoir says there’s nothing in the measure requiring the pharmaceutical companies to sell to the state at a lower cost. They could just refuse. And then what?

“Many of these drugs might not be available through the Medi-Cal program,” Dr. Lenoir speculates. He also fears if drug companies are forced to sell meds at a discount to the state, they’ll just raise prices for people with private insurance. “I think there’s no question that if you put in place a proposition like this, the pharmaceutical companies will try to regain that profit somewhere else.”  

Dr. Lenoir doesn’t think Prop 61 is broad enough to be effective. “This is a small proposition that doesn’t really answer the questions that we need answered around the cost of drugs and the general public,” he says. “And I think we do need serious, serious attention paid to this issue.”

But Jessie Brooks thinks the pharmaceutical companies are just using scare tactics to keep people from voting for Prop 61.

“What we do know is the system that’s in place is not good and it’s not working,” he says. “So why not start with a small group and work our way up to everybody?”

Brooks concedes that it’s not an ideal written proposition, “But I believe that it’s going to start the conversation.”

To Recap:

A vote “Yes” on Prop 61 would limit the amount the state could pay when it buys pharmaceutical drugs. It would affect a few state agencies.  

A vote “no” opposes this limit.

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Crosscurrents HealthElections