By Mary O’KEEFE
By now Crescenta Valley registered voters have received their Official Voter Information Guide. It is a 223-page book that offers five pages of instructions and information with the rest devoted to the 17 propositions on the ballot this Nov. 8.
One of the more complicated propositions is Prop 61. It seems to be tugging at the heart of voters to make them choose, according to commercials supporting and opposing the proposition, between supporting veterans or supporting low-income families and seniors who struggle with prescription medication costs. But as is common with California propositions, the real story is somewhere in the middle and is never a clear cut “Yes” or “No.”
Prop 61 is the State Prescription Drug Purchases, Pricing Standards, Initiative Statute.
At a recent Crescenta Valley Community Association meeting, representatives from the League of Women Voters stopped by to help explain the propositions in understandable language.
If voted in, Prop 61 will prohibit state agencies from paying more for a prescription drug than the lowest price paid for the same drug by the United States Dept. of Veterans Affairs. This applies to any program where the state is the ultimate payer for a drug, even if the state does not purchase the drug directly. Exempts certain purchases of prescription drugs funded through Medi-Cal.
Currently the state purchases prescription drugs under various programs to cover its current employees and prison inmates – anyone who is covered by a state insured program including low-income people through Medi-Cal.
“The state may: 1) purchase drugs from manufacturers or 2) reimburse other entities implementing state programs,” said Rene Leask of the LWV.
The VA, like other significant drug purchasers, typically negotiates with drug companies on the pricing of medication and usually receives discounts off the manufacturer list price. The VA provides health care to over 9 million veterans nationwide.
“[The VA] is subject to federally imposed upward limits on the prices it pays for drugs but often negotiates additional discounts generally to lower prices,” Leask said.
A “yes” on Prop 61 would extend those discounts given to the VA to state agencies, which offer medical coverage to low-income families, which equals about 13 million people.
“The VA maintains a database that lists prices it pays for most drugs; however, the database may not display the lowest prices it pays for some drugs because of confidentially clauses and some VA purchase agreements [that] prohibit public disclosure of some information,” she added.
So finding the actual discounted costs of the prescriptions drug awarded to the VA may be difficult.
Commercials urging a “no” vote on 61 have veterans worried that their medication prices will rise while commercials for “yes” on 61, including one featuring former presidential candidate Bernie Sanders, state the passing of 61 would be good for Californians because it would not only lower costs for needed medication for low-income families but would also save the state money by spending less with drug companies.
The answer, according to the LWV and the Legislative Analyst’s Office, is uncertain.
“The fiscal effects … there is a potential for the state to realize a drug cost reduction but there is a major uncertainty about the amount of savings,” Leask said.
Uncertainties include the ability of obtaining the actual VA pricing information, the potential impact of Medi-Cal rules and the reaction of drug manufacturers.
“The VA public database does not always identify the lowest prices the VA pays … and it may be impossible for the state to obtain this information,” Leask added. “There are at least two responses by manufacturers to Prop 61. One is drug manufacturers might try to raise the VA prices, or two the drug manufacturers could refuse to offer California some drugs purchased by the VA, therefore it appears the amount of any savings in Prop 61 could range from little effect to significant annual savings.”
So the question is: Is it worth the risk to see what drug manufactures will do if Prop 61 is passed and chance getting prescription medication prices down to affordable levels and possibly save the state money?
Contributions to “Yes” on Prop 61 total $14,476,097 (as of press time). The majority of that money came from AIDS Healthcare Foundations contributing $14,409,556 and California Nurses Association contributing $51,003. The rest of the money comes from individuals contributing from $185 to $600.
The “No” on Prop 61 top contributors are drug manufacturers with a total of $86,915,660. Johnson and Johnson, Merck and Pfizer all contributed $7,212,000. Other companies contributed the rest.
The contributions are according to votersedge.org.
For more information on the propositions, visit League of Women Voters of Glendale/Burbank, gb.ca.lwvnet.org, or LWV Pasadena at lwv-pa.org or votersedge.org.