State Issue 2, the so-called drug price relief act, has been hotly contested.
The amount of money being spent on commercials by drug companies to defeat it has broken the state's record for the most spent for a ballot issue.
Supporters of that plan have brought in around $14 million so far, but the drug company-funded campaign to defeat Issue 2 has raised $58 million dollars.
The head of the group behind it says internal polls show it could go either way in Tuesday’s election. Michael Weinstein, who heads the supporters, conceded the drug price relief act is facing an uphill battle because the opponents have a lot more money to spend to sway voters in this final week.
There has been barrage of commercials about state issue two over the past few months but not many facts in them explaining what the ballot initiative would actually do, says Case Western Reserve University health finance professor J.B. Silvers.
“The ads don't tell you anything The ads are just stuff,” Silvers said.
So what are the facts? According to the official ballot language it requires Ohio departments and agencies to not pay more for prescription drugs than the federal Veterans Affairs Department. VA officials say they get about a 24 percent discount off prescription drug purchases.
Getting that same drug discount in Ohio for agencies such as Medicaid and universities would save the state somewhere between $180 million to $536, said Weinstein, President of the California-based AIDS Healthcare Foundation.
“The money saved by this initiative will either go into services that cannot be funded now or a tax cut,” Weinstein said.
Silvers, who conducted an independent analysis of the proposal, says it would possibly lower drug prices for people who work directly for the state, or who are covered by the state but those saving for Ohio tax payers are not a sure thing.
“It’s a guess. There's not a lot of science behind it. So it's a bunch of assumptions. There would definitely be savings there is no question so the arithmetic isn’t wildly off,” he said.
Another analysis by the Ohio Office of Budget and Management found if the issue passes the state could save some money but it’s impossible to say how much.
Part of the reason it’s so hard to know is the price the VA pays for some drugs is secretly negotiated with drug companies and not available to the public says spokesman for the coalition opposing Issue 2, Dale Butland.
“So what happens when Ohio needs to buy drugs that the VA doesn't buy. Can we still buy those drugs because now there is no VA price to compare it? Well we don't know because Issue 2 doesn't tell you. The devil is in the details,” Butland said.
For example, the VA doesn’t purchase drugs for kids and with 40 percent of all Ohio children covered by Medicaid that’s a large chunk of state purchased drugs that won’t be covered.
Silvers agrees there is nothing written in the ballot initiative that gives enforcement power to the state if the drug companies refuse to give Ohio the discount.
He’s also concerned that even if voters give it the green light lawsuits could stop it from being implemented.
“It’s not clear what kind of lawsuits and who would sue but there definitely would be lawsuits,” he said.
The well-funded pharmaceutical companies financially backing the opposition to the drug price relief act are ready for a legal challenge, Silvers said. Issue 2 mandates the state spend money defending those court battles.
Weinstein says the bottom line is many pharmaceutical companies are fearful that if Ohio voters approve issue two it would start a ripple effect.
“They know that this would create a movement that would sweep the country and that private insurers would demand that same price,” he said
Dr. Silvers says the choice for voters on election day may come down to a choice between fear and anger.
“If I believed it was going to work then I could perhaps vote for it as a protest vote against the drug companies and the ridiculously high prices, others will vote against it not because they think it won’t work but because fear they’re gonna raise my prices as a result of doing this,” Silvers said.
No matter what happens in Ohio on Tuesday Weinstein says the supporters already have plans to get this on the ballot in other states, including South Dakota.
