- A vast majority of Ohio voters on Tuesday decided against a ballot initiative that would prevent the state from buying prescription drugs at prices higher than what the Department of Veterans Affairs pays, an outcome that underscores the complex dynamics involved in regulating the cost of medicines.
- Known as Issue 2, the initiative set an Ohio record for the most money ever raised by support and opposition campaigns regarding a ballot initiative, according to the non-partisan political website Ballotpedia. A total of $75 million — the bulk of which came from the pharmaceutical industry trade group PhRMA — had been raised by early November.
- Nearly 80% of Ohio voters opposed Issue 2, and not a single county in the state voted in favor of it, according to data compiled by The New York Times.
Issue 2 mirrors another ballot initiative that failed to pass last year in California. Proposition 61, or The California Drug Price Relief Act, also sought to block the state from purchasing drugs at prices higher than those paid by the VA, which receives at least a 24% discount from the average price offered to non-federal workers.
In addition to their intent, Proposition 61 and Issue 2 have the same big advocates and critics. The AIDS Healthcare Foundation, for instance, donated more than $14 million and $16 million, respectively, to support campaigns for those initiatives. PhRMA, meanwhile, contributed more than $150 million combined to opposition campaigns.
The arguments surrounding Issue 2's passing centered on whether the law would actually lower drug costs. Advocates assert that using the VA as the standard for how spending should commence would save Ohio hundreds of millions of dollars each year in healthcare costs.
"Issue 2 changes Ohio law to ensure we pay the lowest known price for medicine. Ohioans would save $400 million, which would help fund schools, police departments, and cut taxes. Instead, that money goes to drug companies," argued the pro-Issue 2 campaign Ohio Taxpayers for Lower Drug Prices.
The pharmaceutical industry, however, contends the initiative is limited in scope and wouldn't save consumers money like the Ohio Taxpayers for Lower Drug Prices has maintained. Notably, these are the same criticisms the industry lobbed at Proposition 61, which lost by a 54-46 voting margin.
"It imposes a regulatory scheme for state prescription drug purchases that experts say is unworkable and warn could actually increase drug costs," said the opposition campaign, which operates under the name Ohioans Against the Deceptive Rx Ballot Issue. "Issue 2 also gives its sponsors the unprecedented right to intervene in legal challenges to the regulation and requires taxpayers to pay their attorneys fees, win or lose."
Outside of the back-and-forth, Issue 2's failure reflects the complex battle states and consumers have when trying to set caps on pharmaceutical price hikes or government spending on drugs. Money, influence and the overall message of proposed legislation play important roles, and can drastically shape how voters take action.
Survey results from a few months ago found 60% of Ohioans said they didn't know very much about Issue 2. This shows the lack of public knowledge there is about how drug prices are set, and later negotiated.