The conflicting claims in the prescription drug issue that will be on the Ohio ballot in November are enough to cause a headache.
Or even something requiring a prescription.
The most recent flurry of ads last week on broadcast television attacked the previous flurry of TV ads, each accusing the other of deceptive tactics to manipulate Ohio voters.
What to believe?
Issue 2 on the Nov. 7 ballot will be the Ohio Drug Price Relief Act.
The battle playing out so far on TV screens features, on one hand, emotional appeals on behalf of suffering people against “greedy” drug companies. The other side has turned to legalistic points and experts who sound soothing.
If Ohio voters approve the ballot issue, the state government would be required to pay no more for prescription drugs than the prices paid by the U.S. Department of Veterans Affairs, typically a discount of up to 24 percent.
According to proponents, it would apply to approximately 4 million Ohioans made up of Medicaid recipients, workers compensation recipients, state employees, and state retirees. Medicaid recipients make up more than 75 percent of that group.
VIDEO: Deceptive RX Issue
Proponents say a “yes” vote would save taxpayers $400 million a year because the measure “finally forces drug companies to consider the health care of people over lining their own pockets,” said Dennis Willard, spokesman for Ohio Taxpayers for Lower Drug Prices.
Opponents are equally adamant, contending the campaign is based on faulty assumptions and bad math and will have the effect of actually driving up the cost of prescription drugs.
Neither campaign is funded by grassroots contributors.
Ohio Taxpayers for Lower Drug Prices has received all of its money — roughly $2.47 million, as of Dec. 31, according to the Ohio Secretary of State — from a foundation headed by Los Angeles AIDS activist Michael Weinstein. Mr. Weinstein bankrolled a similar ballot question in 2016 in California that failed.
On the other side is Ohioans Against Deceptive Rx Ballot Issue. The bulk of the money to defeat the ballot issue is being provided by drug manufacturers, although the organization was formed too recently to have had to report financial information.
According to Ohio Taxpayers for Lower Drug Prices, pharmaceutical companies spent $110 million to defeat the issue in California, where it failed by six percentage points.
A recent ad from the proponents’ side attacks opponents’ ads. It depicts the opponents’ speakers — attractive people in warm, reassuring settings, speaking in believable voices. Then the picture changes to reveal black and white photos of scary-looking men who appear to be manipulating the message. They represent the pharmaceutical companies.
“And they think we’re too stupid to even realize it,” the ad says.
“We’re setting the record straight,” Mr. Willard said. “Our opposition and their grossly misleading TV ads are funded by drug companies and their greedy CEOs who are pouring millions of dollars into this campaign because they desperately want to protect their huge profit margins. You can’t trust what they say.”
“That’s all they do,” countered Dale Butland, spokesman for Ohioans Against Deceptive Rx Ballot Issue. “That’s the only message they have, which is to rail against the evil drug companies. No matter what you think of the drug companies, none of those things are going to be on the ballot this fall.”
Ohioans Against Deceptive RX Ballot Issue touts a large number of endorsers, including 60 statewide organizations, such as the Ohio Nurses Association and the Ohio State Medical Association. Other groups are Veterans of Foreign Wars, Equitas Health (Ohio’s largest HIV/AIDS organization), the Drug Free Action Alliance, Ohio State Grange, and the Columbus Branch of the NAACP.
The organization also has medical and budget professionals with impressive credentials, including women who were Medicaid directors under Democratic Gov. Ted Strickland and Republicans George Voinovich and Bob Taft. Also against the ballot issue is Greg Browning, who was the state’s budget director from 1991 to 1998.
Mr. Butland said only the pharmaceutical companies have the money to mount the education campaign needed to defeat the ballot issue.
He said there are many problems with the ballot proposal. Among them are that:
● It would require the state to pay for prescriptions no more than what the VA pays. But Mr. Butland said the VA negotiates secret additional discounts. Since those discounts are secret and can’t be seen by the state of Ohio, how can Ohio know what price to pay?
● What about prescriptions that the VA doesn’t buy? As a veterans’ service organization, the VA may not need all the drugs that the state of Ohio needs. If the VA doesn’t buy a drug, how can the state know what to pay for it? “You can’t force drug companies to sell their products at VA prices,” Mr. Butland said.
● Unlike the VA, which buys in bulk and distributes its pharmaceuticals, the state of Ohio only reimburses pharmacists who sell drugs to state employees, retirees, and Medicaid recipients. The proposal only controls the price the state is allowed to pay. What if the drug companies refuse to give the discount to the pharmacists? Mr. Butland said those pharmacists will drop out of the Medicaid program rather than lose money on each prescription.
● Opponents also contend that the proponent campaign overlooks the fact that 75 percent of the drugs bought by Ohio are for Medicaid, and that Medicaid already gets a federally mandated discount of 23 percent, virtually the same discount that the VA gets.
Last week, Mr. Browning attacked the ballot proposal as “simply false and without merit.” He said Ohio already gets “significant discounts” on prescription drugs through Medicaid, so most of the $400 million in savings supposed to be gained by the ballot initiative is already accounted for.
He issued an analysis claiming the group made faulty calculations, basing its estimates on the “net” expenditures in the 2015 fiscal year for Medicaid recipients. The net spending that year was $1.5 billion.
The actual spending was more than $2 billion, from which the state gained 23 percent discounts on brand-name drugs and significant other discounts, thus reducing the cost to $1.5 billion, Mr. Browning said.
“In other words, Ohio is already receiving a discount of well over 25 percent on the vast majority of the drugs it purchases,” Mr. Browning said in an analysis distributed by Ohioans Against the Deceptive Rx Ballot Issue.
The proponent group scoffs at Mr. Butland’s parade of medical and budget professionals as hired guns.
“We stand by our numbers and we don’t trust the analysis of someone who’s paid for by drug companies,” Mr. Willard said.
He dismissed all of Mr. Butland’s arguments as misleading, saying those kinds of problems will be resolved under the law because big drug companies won’t walk away from the Ohio prescription drug market.
“Why would they be spending tens of millions of dollars unless this was going to have an impact on their price-gouging bottom line?” Mr. Willard said. “It doesn’t pass the smell test. We believe that they’re using bad math and distorting the facts.”
He said the VA’s “formulary,” or list of prescription drugs and prices, is online and is easily referenced.
“This program works in the VA and it will work in Ohio. The drug companies have not pulled out of the market in the VA or in other countries like Canada because even when they reduce prices by 20 to 24 percent they’re making a profit,” he said.
VIDEO: Ohio for Lower Drug Prices
VIDEO: Deceptive RX Issue
“Outside all of these esoteric arguments, there are people cutting pills in half, making decisions whether to put food on the table or pay for drugs. There are victims of this, not to mention our state budget is out of balance and it’s a way to address the imbalance in the state budget,” Mr. Willard said.
Mr. Butland said outside experts were paid for their time, including Mr. Browning and three former state Medicaid directors. He said no one who appears in the TV ads was compensated and none of the 60 organizations that joined the campaign has received any money.
“Revealingly, the ‘yes’ side has never once challenged those experts on their facts or their findings. Instead, they seek to impugn their integrity through innuendo and insinuation," Mr. Butland said.
Opponents have also taken issue with a provision that allows the pro-Issue 2 committee to defend the law in court, and have the state pay their legal expenses.
Guidelines: Please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Comments that violate these standards, or our privacy statement or visitor's agreement, are subject to being removed and commenters are subject to being banned. To post comments, you must be a registered user on toledoblade.com. To find out more, please visit the FAQ.