We recently wrote about Proposition 61 in California – a measure that would have required drug makers to provide large discounts to state agencies that serve HIV patients, retirees, inmates, and low-income residents. On Election Day, after months of campaigns (both for and against the Proposition), California voters rejected the measure by a vote of 54% to 46%.
As we have previously noted, the law, while it may sound good in theory, had the potential to force the pharmaceutical industry to raise drug prices for veterans and others who benefit from public assistance programs in California.
Known as one of the most expensive ballot propositions in the history of California, proponents pulled out all their stops in an attempt to pass the measure, even airing television ads and bringing Bernie Sanders in to hold rallies in Los Angeles and Sacramento. During a November 7 rally, Sanders closed his remarks by saying Proposition 61 “could be the shot heard ‘round the world,” referring to the domino effect in pricing that the measure’s proponents had been touting. Proponents felt that if they pegged California state agencies to the VA’s price scale for drugs, that it would serve as an example to all state Medicaid programs in the country, and thereby indirectly lower the prices for drugs paid by private insurers.
It wasn’t just the pharmaceutical industry that opposed the measure, however. California citizens who opposed the measure believed that the pharmaceutical companies would have shifted their losses onto the backs of consumers who would not be covered by the measure. Many patient advocacy groups also came out against the measure, as it was entirely possible to them that they settle on drug pricing of medicines that are less costly, more easily accessible, and dangerous to patients.
Rollercoaster of Polls
As recently as just two months ago, the proponents were ahead by a 2-to-1 margin, according to a USC Dornsife/L.A. Times poll conducted September 1 through September 8. That poll found that a full two-thirds of California voters supported Proposition 61.
Following that poll, pharma and its partners “turned up the heat” and spent an additional $22.3 million in advertising against the proposition. It wasn’t just Pharma that opposed the proposition, however. The California Medical Association, representing the interests of over 43,000 California physicians, as well as essentially every veterans organization, who argued that the measure would have prompted drug companies to boost their prices on veterans, even though federal law protects veterans from price hikes on medicine.
Even in the end, the defeat was surprising to many that were paying attention, especially when you take into consideration that polls taken earlier in the falls showed widespread support for the initiative. The measure was introduced in the midst of the widespread backlash to rising drug prices.
According to Darius Lakdawalla, a health economist at the University of Southern California, “there are so many forces that are aligning for some kind of public policy or regulation on pharmaceutical devices. I don’t think this “no” vote really stops that. There’s too much frustration.”