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COL Court OKs Maine drug plan

Program cuts prescription prices for needy patients

An ingenious plan by the state of Maine to help needy residents buy prescription drugs has been given a preliminary OK by the U.S. Supreme Court.

Under the program, the state would use its buying power in the Medicaid program to get lower rates for beneficiaries of that program and for other low-income residents without health insurance. The state would ask drug manufacturers to provide rebates that would be placed in a fund to reward pharmacists who sell drugs at a discount to Medicaid recipients and other needy residents of the state who lack health insurance.

If a drug company refused to comply, it would have to seek state authorization for sale of any of its products in Maine. Pharmaceutical companies have said the plan would put state officials, rather than doctors and pharmacists, in charge of deciding which medicines could be prescribed for these clients and would thus violate the law because the decisions would not be based on patients' needs.

In overruling a lower court's ruling blocking the Maine Rx program, the Supreme Court indicated that drug makers would have an opportunity to renew their objections after the program takes effect.

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Twenty-nine states, including Minnesota, signed a legal brief that supported Maine's position in the case. In addition, Minnesota and 17 other states have proposed legislation that would set up programs similar to Maine Rx.

Drug manufacturers originally filed a suit objecting to the program in the U.S. District Court in Portland, Maine. That court ruled in favor of the drug companies, but the appeals court in Boston overruled its decision.

Members of the Supreme Court ruled 6-3 that the program could proceed, but they differed on a number of subsidiary issues, including whether the program should have been approved by the U.S. Health and Human Services Department. Justice Steven G. Breyer filed a separate opinion in which he said that the HHS department should make its position on the Maine program clear if there is any further litigation.

Maine has 300,000 citizens -- out of a population of 1.3 million -- who lack health insurance.

In effect, the state is simply following a practice by privately owned managed care companies that use their buying power to negotiate discounts from drug companies. Drug companies fear adoption of that practice by state or federal agencies would limit their profits.

The fact is that U.S. citizens pay far higher prices for prescription drugs than most other countries, many of which simply impose price controls. As a result, Americans pay steep prices to finance drug companies' costly research and advertising programs and residents of other countries get the benefits.

There is no logical reason for that arrangement, which results from the drug manufacturers' heavy spending for lobbying Congress and for lavish campaign contributions.

High prices for prescription drugs are a heavy burden for millions of Americans who cannot afford health insurance. While the Maine program is a step in the right direction, it may well be nullified by future litigation.

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It is time for members of Congress to face reality and address the issue directly by exercising control over the prices of prescription drugs as other countries have done. After all, the Maine Rx program -- approved by the Supreme Court -- is simply a form of price control imposed by different means.

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