In the fight between people and profits, people just won a round. Until Monday, the state of Maine had been blocked in its effort to implement an innovative drug discount program for the uninsured by pharmaceutical industry legal maneuvers. The $400-billion-a-year industry, long the nation’s most profitable, has been fighting initiatives to curtail drug costs in state after state, but the Maine case was the first to come before the Supreme Court.

Now the Supreme Court has ruled. The “Act to Establish Fairer Pricing for Prescription Drugs,” or Maine Rx, as the program is popularly known, can go forward. That’s good news for all of us here in Maine, but especially for the 325,000 who lack prescription drug coverage.

Of AARP’s 35 million members, 192,000 reside in Maine. About half of them lack adequate coverage. So AARP worked with the attorney general, the Maine Citizen Leadership Fund, Maine Council of Senior Citizens and national groups such as Families USA and the Medicare Rights Center, to file an amicus curiae (“friend of the court”) brief in support of Maine Rx. Twenty-nine states did the same thing.

Little wonder.

Prescription drug spending grew at an annual rate of 13 percent in the U.S. between 1993 and 2000, when it reached $132 billion. That’s more than the nation spends for electricity, telephones, new cars, and men’s and boy’s clothing combined. It is projected to keep growing at a similar pace through 2011. Meanwhile, prices for brand-name prescriptions are rising nearly four times as fast as the inflation rate.

States are among the drug industry’s biggest customers. But they’re reeling from budget shortfalls expected to reach $89 billion next year, and they can’t keep up. Neither, needless to say, can the 55 million people who lack prescription coverage nationwide, including some 13 million people on Medicare.

Ask Andre Boucher of Windham. He worked in a paper mill for 40 years, which took a toll on his heart and lungs. The eight medicines he takes every day cost him $7,200 a year out-of-pocket. Meanwhile, his wife, Janice, who has asthma, must spend $2,400 more.

I learned about the Bouchers at the “kitchen-table” workshop AARP held in Portland back in August to highlight the need for a Medicare drug benefit. Hundreds showed up at similar events across the country. Everybody had their own stories to tell. People forced to choose between buying food and buying the medications they need. Some cut back on the recommended dosage for a drug. Some just do without. A good many of them are middle-class retirees, shocked to find so much of their retirement income going for prescription drugs.

As of 1999, Medicare beneficiaries made up 15 percent of the population, but accounted for 40 percent of total drug spending. Their average out-of-pocket spending for prescription drugs was $860 in 2002, according to the Congressional Budget Office. About 750,000 beneficiaries spent over $5,000 each. To add insult to injury, if you don’t have drug coverage, you pay top dollar – more than half again what Medicaid or an HMO might pay, according to the Center for Policy Alternatives.

Savings under Maine Rx, reportedly, could run to 20 percent or more. The law encourages drug manufacturers to negotiate discounts with the state to be passed along to Maine Rx cardholders at participating pharmacies. If a manufacturer refuses to negotiate discounts, that company’s drugs would then be made subject to “prior authorization” under Maine Care, the state’s Medicaid program, if clinically appropriate. Doctors wishing to prescribe drugs subject to the requirement, would have to receive prior authorization from the Department of Human Services before doing so.

Hawaii adopted a law similar to Maine Rx last year. Some 18 other states have their own programs in the works. More will likely follow. Since Medicaid is a $20 billion-a-year piece of business for drug manufacturers, they can’t afford not to negotiate with the states now, unless – a possibility the Supreme Court left open – the secretary of Health and Human Services were to determine that Maine Rx is not in the best interests of Medicaid recipients.

I believe if Maine Rx is given a chance to work, the evidence will overwhelming show that it is in the best interests of Medicaid recipients as well as others needing help. But I also recognize the fight isn’t over. In fact, the ring could get a little crowded with judges, administrators, politicians and lobbyists all weighing in. One solid punch, though, would go a long way toward easing the pressure of high drug costs on states and consumers. It’s a punch only Congress can throw. I am speaking, of course, of a meaningful Medicare prescription drug benefit – one that takes full advantage of the program’s potent bargaining power. It’s way past time Congress rose to the people’s defense and let it fly.

Jud Dolphin is Maine state director of AARP.