Officials applaud Rx plan victory Drug companies consider options

AUGUSTA – Their interlocked and outstretched arms raised in a symbol of victory, supporters of the Maine Rx program promised Thursday that a recent federal appeals court decision will usher in dramatic cuts in prescription drug prices for uninsured Mainers.

“Ordinary Maine people will be able to get the drugs they need without necessarily having to face the terrible choice between the rent, the food and the medicine,” said Gov. Angus King. “This won’t make pharmaceuticals free, but we’re talking about between a 20 [percent] and 30 percent reduction in price to virtually every citizen in Maine who’s not already in a drug program in their HMO, or health insurance or in the Medicaid program. This is a huge dollar benefit to the people of Maine.”

Meanwhile, the Pharmaceutical Research and Manufacturers of America, or PhRMA, issued a press statement Thursday expressing its “disappointment” with the appeals court decision that lifted a preliminary injunction granted to the industry in October by a federal court judge in Maine. The drug companies had argued that the Maine Rx program restrained trade by attempting to regulate commerce outside the state.

Options for a possible appeal to the U.S. Supreme Court still were being considered according to Marjorie Powell, a lawyer for PhRMA. Powell said her organization would be watching the implementation of the law – the first of its kind in the country – which will permit the state to negotiate drug prices with the major drug companies for up to 325,000 Mainers who do not have insurance for prescription drugs. It also allows the state to impose price controls after three years if drug company negotiations fail to produce the expected reductions in drug costs.

Powell was particularly critical of one section of the law that permits Maine to use “prior authorization” to encourage companies to negotiate price reductions with the state Department of Human Services. Powell said “prior authorization” makes it more difficult for companies to offer their products through Medicaid by requiring doctors to seek approval from “state bureaucrats before they can prescribe the particular medicine they feel is best for the patient.”

“Prior authorization would put Medicaid patients at the back of the health care line when it comes to state-of-the-art medicines,” Powell said.

Concern over such criticism was nonexistent during a Thursday press conference on the steps of the State House where King gathered with DHS Commissioner Kevin Concannon, Maine Attorney General Steven Rowe and former Senate Majority Leader Chellie Pingree, D-North Haven. Another 20 or so legislators, lawyers and analysts who worked on the law stood behind the keynote speakers.

Pingree, who recently announced her intention to seek the Democratic nomination for the U.S. Senate next year, was particularly pleased with the decision as the original sponsor of the landmark bill.

“Today is an excellent day for the people of Maine and the people of the entire country,” Pingree said. “We knew in the beginning that we were right and we worked very hard to craft a bill that would stand up to this legal test and we did a very good job defending it as the state of Maine.”

All four speakers said others have been watching the unfolding legal challenge to determine the feasibility of initiating Maine-modeled programs in their home states. Pingree said she frequently has been called for advice or information about the court case.

“Today we can go back to all of them and say we have sustained a court challenge and that you go ahead and do this in your state,” she said. “This legal decision said to us it is a good thing for states to be bold; it is a good thing for states to act on the behalf of their citizens.”

Rowe made a point of complimenting legislative senior analyst Jane Orbeton and assistant attorneys general Andrew Hagler and John Brautigam for their help in crafting the law and defending the state’s appeal to the U.S. 1st Circuit. Hagler said the appeals court thoroughly considered all of the constitutional issues in the 3-0 ruling that held that the Maine statute passes muster.

“This may prove to be an important precedent in a long line of cases affirming the valuable role of states as laboratories of public policy,” Hagler said.

King and Concannon said they knew the courts would be watching how Maine plans to implement its new program, which could get under way as soon as this summer. The DHS chief said the Maine Rx program’s success can be credited to the “good accountants and good lawyers” who were able to defend the proposal in the appeals case.

“There are many states watching this who I think will now take heart and emulate what the state of Maine is doing,” Concannon said.