This fall, Ohio voters will decide Issue 2, which would require the state to pay no more for prescription drugs than what is paid by the U.S. Department of Veterans Affairs.
Members of Yes on Issue 2, the committee behind the proposal, said they are trying to save Ohioans money on prescription-drug costs.
Members of Ohioans Against the Deceptive Rx Ballot Issue, an opposition group that includes medical associations and pharmaceutical groups, called Issue 2 "deceptively attractive" and bad public policy.
"It's unworkable and it's not going to do what it promises in terms of delivering affordable prescription drugs," said Dale Butland, spokesman for the anti-Issue 2 group.
Issue 2, also known as the Drug Price Standards Initiative, would require the state and state agencies, including the Ohio Department of Medicaid, to pay the same or lower prices for prescription drugs as the VA, which under federal law receives a 24 percent discount for prescription drugs, according to Health Affairs, a health-policy journal.
The state -- as is the case with the VA -- negotiates voluntary additional discounts and rebates with drug retailers that cannot be revealed by federal law, Butland said.
He said the United States Code's Title 38 VA statute includes the provision for confidentiality with the drug contracts.
"We don't know what the lowest price is paid by the VA," Butland said. "It's setting up a standard that would be impossible to meet."
In addition, Butland said, 75 percent of drugs purchased by the state are for Medicaid recipients, who already get a 23.1 percent discount under federal law.
The state made an outlay of $2 billion in 2014 for Medicaid drug purchases, according to Greg Browning, the former Ohio budget director and president of Capital Partners, a public-policy and management-strategy company based in Columbus.
With the discount and subsequent reiumbursement from the pharmaceutical companies, the net expenditure was about $1.5 billion, he said.
Dennis Willard, representing the pro-Issue 2 committee, countered that the practice already is working.
He said the VA has been negotiating drug prices for 25 years, starting when troops came back from the first Gulf War and drug companies reportedly were gouging them.
Butland said two-thirds of Ohioans -- or roughly 7 million people -- are left out because they do not get their prescriptions through state programs.
He said he sees the program backfiring, raising drug prices for a majority of Ohioans and reducing access to needed medicines for some of the state's most vulnerable citizens.
Willard called that a "scare tactic."
"First of all, that's assuming everyone in Ohio is purchasing prescription drugs," he said.
With a mandatory ceiling in place, Ohioans won't get saddled with the higher drug costs, Willard said.
"Not paying this benefits everybody," he said.
Butland argued that the law can't require manufacturers to sell drugs at a certain price. If the manufacturers say they will not sell at that price, Ohio could not be allowed by law to buy them and the drugs would be off the market, he said.
"This is just an example of just how poorly conceived this initiative is," Butland said.
Willard said those were empty threats.
"Somebody will fill the void," he said.
According to several outlets, including cleveland.com, California businessman Michael Weinstein, founder and director of the AIDS Healthcare Foundation, is behind the push for Issue 2.
Weinstein also supported Proposition 61, a ballot issue that failed last year in the Golden State, according to the Los Angeles Times.
If Issue 2 were approved, a provision would give its sponsors a legal right to intervene in any lawsuit that may be filed against it and would require the state to pay those attorney fees, for which there is no cap, according to Butland.
The ballot language also said the petitioners would be required "to pay $10,000 to the state if the law is held by a court to be unenforceable" and the attorney general "would be required to defend the law if challenged in court."