Maine Rx Program Buoyed by Court Decision

Maine is moving to implement a prescription drug cost control program following a U.S. appeals court ruling against the Pharmaceutical Research and Manufacturers of America (PhRMA), which had sued to block Maine Rx. Kevin Concannon, commissioner of the Maine Department of Human Services, called Wednesday's decision by a three-judge panel to lift an injunction that had put the controversial program on hold "unambiguously a grand slam."

A first-of-its-kind initiative, the program was created by the legislature last May. It seeks to provide low-cost prescription drugs for uninsured Maine residents who aren't poor enough to qualify for Medicaid or the states' Drugs for the Elderly and Disabled Program.

Maine Rx would require drug manufacturers to offer discounts to an estimated 325,000 state residents who lack health insurance. The program also provides for standby drug price controls.

Maine Department of Human Services Commissioner Kevin Concannon called Wednesday's decision by a three-judge panel to lift an injunction that had put the program on hold "unambiguously a grand slam."

"It will reenergize states across the country. I [suspect] this morning PhRMA was taking Prilosec to deal with upset stomachs," he said.

PhRMA's assistant general counsel Marjorie Powell expressed "disappointment" with the ruling and said the trade group was mulling additional legal avenues to block the program.

"We may ask for a re-hearing by all of the First Circuit [since the decision came from a panel within the court], file a request with the Supreme Court or go back to the district court judge and ask him to look at any unclear provisions about how the state would go about implementing the law," she said

Powell said her organization will make its decision "within a short while" and added that PhRMA will be closely watching what happens in Maine as officials move forward with the program.

Legislators who focus on health policy in other states were encouraged by the Maine decision. Legislation that would create programs similar to Maine Rx was introduced in 27 states this year, according to the National Conference of State Legislatures. Thirteen states took no action, but the legislation is still pending in 14 others.

In Massachusetts, Representative Pat Jehlen, author of one of the copycat measures, said the ruling was "great news." Jehlen's bill is currently stalled in committee, but members of the Massachusetts House have okayed a budget provision that lets the commonwealth negotiate prices on prescriptions drugs.

"It doesn't have rebates and it doesn't set target [prices]... but I think we're just going to pursue everything we can," she said.

California Senator Jackie Speier, who sponsored a Maine-like bill that went nowhere last year, called the court ruling "phenomenal." Legislators in the Golden State are considering several prescription drug bills this session, including a Speier measure that would expand a discount drug program via voluntary rebates from drug manufacturers.

In New York, Senator Kemp Hannon, who chairs the Senate Health Committee, says he now plans to "take another look" at some measures he's put on hold to see what can be done. Hannon says two types of legislation will gain some steam from the Maine ruling-- group pharmacy purchasing within a state (lumping seniors with people on Medicaid and state employees) and multi-state purchasing pools like that of the New England states.


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