Calif. Voters to Decide Prescription Drug Battle

California voters will face a confusing pair of initiatives on Tuesday. Propositions 78 and 79 both appear to offer drug discounts. But Kenny Goldberg of member station KPBS reports that one is supported and funded by large pharmaceutical companies and requires only voluntary compliance, while the other is supported by consumer groups and requires mandatory drug cost cuts.

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MADELEINE BRAND, host:

This is DAY TO DAY. I'm Madeleine Brand.

In California, the pharmaceutical industry is in a fierce political battle with consumer groups. At issue is how best to give prescription drug discounts to poor people. Both sides have put initiatives on next Tuesday's ballot. From member station KPBS in San Diego, Kenny Goldberg reports.

KENNY GOLDBERG reporting:

In her small east San Diego County home, Nettie Steele(ph) puts a tray of prescription drugs on her kitchen table.

Ms. NETTIE STEELE: The first one here is insulin. It costs me about $70 a month. And then we've got Levoxyl for my thyroid problem. And we have blood pressure medicine. And we have Estrace, which is a hormone, 'cause I had a hysterectomy.

GOLDBERG: All told, Steele pays about $240 a month for her medications. Steele is on a low income and says she can't afford health insurance.

Ms. STEELE: You know, it's a monthly concern coming up with the money for this. And when the doctor says he wants to add another prescription to my list, I usually tell him I just can't afford anymore. So that's the way it is.

GOLDBERG: But Steele and millions of other low-income Californians could soon catch a break. Next Tuesday, voters will be asked to decide between two competing prescription drug discount measures. Prop. 78 is backed by pharmaceutical companies. The measure would offer drug discounts to an estimated five million Californians. Julie Corcoran is with PhRMA, the main drug industry trade group.

Ms. JULIE CORCORAN (PhRMA): Prop. 78 is a program that will provide real help right now to millions of Californians who are currently having difficulty accessing affordable medicine.

GOLDBERG: Corcoran says low-income Californians would get drug discounts of around 40 percent off retail, but there are no guarantees. That's because under Prop. 78, participation by drug companies would be voluntary. That's not the case with Prop. 79, the measure sponsored by consumer groups. Under that initiative, companies that refuse to offer discounts could be shut out from California's Medicaid program, which purchases some $4 billion worth of drugs each year. Anthony Wright is executive director of the non-profit advocacy group Health Access.

Mr. ANTHONY WRIGHT (Executive Director, Health Access): So the major difference is enforcement, whether we actually expect the drug companies to lower their prices voluntarily or are we going to use our bargaining power to negotiate a cheaper price so Californians don't have to pay more than anybody else in the entire world for prescription drugs.

GOLDBERG: Prop. 79 also has looser income standards, so it would cover about twice as many Californians as Prop. 78.

As voters consider their choices, which measure would deliver the most benefit to low-income Californians? Geoffrey Joyce, a senior economist at the non-partisan RAND Corporation, says the consumer advocate-backed measure would extend bigger discounts for lower- and middle-income folks, but there's a problem.

Mr. GEOFFREY JOYCE (RAND Corporation): The downside is I think the likelihood of 79, if it passed on November 8th, of actually being implemented is unlikely. I think it would be delayed in the courts for quite some time. Conversely, 78 would likely, if it passed, be implemented fairly quickly.

GOLDBERG: But a new statewide poll shows neither measure has the support it needs to pass next Tuesday. The poll's director, Mark DiCamillo, isn't surprised.

Mr. MARK DiCAMILLO (Poll Director): In the case of multiple initiatives on the same topic, voters get confused. So they just start to generalize the concerns or problems that they may have with one of the initiatives with both of the initiatives.

GOLDBERG: If by chance both measures are approved, the one with the most votes will prevail. For DAY TO DAY, I'm Kenny Goldberg in San Diego.

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