The Ohio Pharmacists Association (OPA) joined more than 80 different health organizations, civic organizations, veterans groups, taxpayer organizations, business groups, unions and patients in opposition to Issue 2, the so-called “Ohio Drug Price Relief Act." Issue 2 was also opposed by nearly every major newspaper in the state of Ohio. Ohioans soundly defeated the measure on Election Day. We thank all of our members for getting out to vote and educating your friends and neighbors about how flawed Issue 2 was.
As part of the Ohioans Against the Deceptive Rx Ballot Issue coalition, OPA worked extremely hard to defeat a measure that could have had serious negative consequences for pharmacies, payers, employers, veterans, and patients. While the initiative created a great opportunity to discuss the flaws with pharmaceutical pricing, unfortunately Issue 2 would have likely make matters worse.
Given that initial polling on Issue 2 showed it passing by a large margin, OPA and our coalition members worked incredibly hard to reverse the numbers, and unofficial results show vote totals at 21% YES and 79% NO.
Our work helped to completely flip public sentiment from significant support to overwhelming opposition.
Issue 2 was a major threat, and would have likely:
The "Ohio Drug Price Relief Act" would have prohibited Ohio’s state government from paying any more for prescription drugs than the lowest price paid by the United States Department of Veterans Affairs.
> Collaborated with other medical and non-medical opponents
> Interviewed by major news organizations
> Participated in debates and townhalls statewide
> Distributed information through OPA Member communications:
> OPA Members and Past Presidents appeared in TV commercials and in mailers
> Answered numerous public and Member calls to clarify opposition to Issue 2
Specifically for pharmacists, this measure was extremely concerning due to its bad wording and seemingly poor understanding of how prescription drugs are bought and sold. While Issue 2 would have prohibited government programs from paying any more than VA prices for prescription drugs, there was no requirement that pharmacies would be able to buy those drugs at the VA rates as well. So pharmacies would be buying drugs at their current commercial rates from their wholesaler, but only receive a fraction of the reimbursement that they would normally receive. It's kind of like what's happening in Medicaid managed care today; but it would have been way worse.
Even if the measure were workable (which it likely wouldn't, due to VA prices being confidential), pharmacies could have ultimately been the biggest losers in the equation, as they would have had to shoulder the burden of the cuts. And while pharmacies would have been getting dramatically under-reimbursed, pharmaceutical companies and pharmacy benefit managers (PBMs) would have been largely unaffected and free to perpetuate the current model that has resulted in the enormous price hikes we are seeing today.
Furthermore, there was no guarantee that the VA rates will remain what they are today. Currently, pharmaceutical companies give steep rebates and discounts to the VA program. If all of a sudden, those VA rates would have been used as a benchmark for other programs, then pharmaceutical companies could just end the discounts for the VA, and charge everyone higher prices.
Additionally, this initiative could have restricted access to medication. The VA program has its own unique formulary, with special rebates given in return for preferential treatment or exclusion of certain drugs from that formulary. The nature of these rebate agreements for the VA would mean that patients could have had decreased access to medications if a particular medication was not included within the VA’s formulary.
There was also no requirement that pharmaceutical companies charge the same prices to all. So if the government and VA were to enjoy all the major discounts that were being sought by Issue 2, pharmaceutical companies could have just raised the prices for everyone else to offset those losses. This would mean that the government would get the benefit, but working Ohioans would have been stuck with the bill.
A bit more simply, imagine if the government required Starbucks to give a 25% discount to a third of their customers. What would Starbucks likely do? They could refuse to sell coffee to the people who are mandated to get the discount. They could raise the cost of coffee for two-thirds of their customers who don't get the discount. They could just raise the list prices of their coffee entirely so that the 25% discount meant nothing to their overall bottom line. Keep in mind, that under this scenario, all of these premises would have applied to pharmacies and prescription drugs. Building on this example, nothing actually lowered the overall price of coffee— just like under Issue 2, nothing actually lowered the overall price of prescription drugs. In fact, the likely outcome was either a loss of access, or the elevation of prices for a majority of consumers. No matter how you slice it, Issue 2 was fundamentally flawed and incredibly reckless.
“The members of the Ohio Pharmacists Association know all too well of the struggles patients have in affording their medications," said OPA Executive Director Ernest Boyd. "As an organization, we have spent years trying to address and change an outdated, opaque drug pricing model that incentivizes members of the medication supply chain to drive up the cost of prescription drugs. Through our work, we know there is a critical and immediate need to implement responsible solutions to lower drug costs – unfortunately, Issue 2 not only missed the mark; but it actually could have raised drug prices. Ultimately, despite the stated intentions of its proponents, the proposal was ill-conceived, poorly crafted, unworkable, and could result in less access and increased costs for millions of Ohioans – including the very patients the proponents claim to want to help.”
"Issue 2 might be the best thing that never happened," said OPA Director of Government & Public Affairs Antonio Ciaccia. "Thanks to much of the recent news coverage, the public is well aware of the current unsustainable trends of drug prices, and now we can get to the serious business actually fixing this mess. The pharmaceutical marketplace is opaque and anti-competitive thanks to layers of middlemen who add darkness and bureaucracy to the system. It's time to pull back the curtain, encourage true competition, and cut the fat."
Also, check out OPA Past Presidents Steve Burson and Jeff Bartone in a recent ad featuring a myriad of health care professionals united against Issue 2:
Additional coverage and resources:
Issue 2 trouncing won’t end debate over high drug prices - Dayton Daily News, 11/8/17 *OPA Government Affairs Director Antonio Ciaccia interviewed
State Issue 2 fails big - Dayton Daily News, 11/7/17 *OPA Past President Marc Sweeney interviewed
Pharmacist Ray Carlson interviewed by Louie B. Free on Issue 2, PBMs; Part 1, Part 2 - Facebook Live, 11/2/17 *OPA Past President Ray Carlson interviewed
Why Ohio’s medical community says vote no on Issue 2 - USA Today, 10/30/17 *OPA opposition mentioned
Editorial: Vote 'No' on Issue 2 - Sandusky Register, 10/30/17
Locals: Lower drug prices good, Issue 2 not so much - Bellefontaine Examiner, 10/28/17 *OPA member Jeff Holycross interviewed
Editorial: What if Issue 2 passes? Get ready for more uncertainty and much litigation - Akron Beacon Journal, 10/27/17
Editorial: Yes on Issue 1, No on Issue 2 - Newark Advocate, 10/27/17 *OPA opposition mentioned
Editorial: Voters should say no to Issue 2 - Star Beacon, 10/24/17
Health Matters radio show: Issue 2 and Antonio Ciaccia, Ohio Pharmacists Association - Health Matters, 10/23/17 *OPA members Paul & Brad White interview OPA Government Affairs Director Antonio Ciaccia
Why doctor and hospital groups are fighting a measure to rein in drug costs - STAT News, 10/19/17
Editorial: Ohioans should vote no on Issue 2 - Columbus Dispatch, 10/18/17
Editorial: Pharma industry needs scrutiny but Issue 2 is not the right fix - WCPO Cincinnati, 10/18/17 *OPA opposition mentioned
Editorial: No on Issue 2 - Findlay Courier, 10/18/17
Issue 2 FAQ: What you need to know before you vote - Cleveland Plain Dealer, 10/17/17 *OPA opposition mentioned
Editorial: Issue 2 is bad medicine - Crain's Cleveland Business, 10/15/17
Deb Randall: How should I vote on Issue 2? - Lima News, 10/14/17 *OPA Board Trustee Deb Randall published opinion piece
State concludes Issue 2 won’t likely result in savings - Dayton Daily News, 10/11/17
NBC4 leads statewide forum to get the facts on issue 2 - NBC4 Columbus, 10/10/17
Battle over Issue 2 heats up - WFMJ Youngstown, 10/9/17 *OPA Government Affairs Director Antonio Ciaccia interviewed
Issue 2: What you need to know before you vote - FOX 45 Now, 10/9/17 *OPA Past President Marc Sweeney interviewed
What could Issue 2 mean for you? A closer look at Ohio's drug pricing proposal - WLWT Cincinnati, 10/9/17 *OPA opposition discussed
Yes vs. No on Issue 2: What they’re saying on both sides - Dayton Daily News, 10/8/17 *OPA member Nnodum Iheme and OPA Executive Director Ernie Boyd quoted
Editorial: Not good medicine for Ohio - Morning Journal, 10/6/17
Cleveland Clinic files 'cease and desist' order against Yes on Issue 2 group - Cleveland Plain Dealer, 10/5/17
Issue 2 fact check: Does Issue 2 cut taxes in Ohio? - Cleveland Plain Dealer, 10/5/17
Panelists clash over state question dealing with drug prices - Sandusky Register, 10/4/17 *debate featuring OPA Executive Director Ernie Boyd
Who is Michael Weinstein, the man behind Issue 2? - Dayton Daily News, 10/2/17 *featuring comments from OPA Government Affairs Director Antonio Ciaccia
Your questions answered about Issue 2 - Dayton Daily News, 10/2/17 *OPA opposition discussed
Face The State with Scott Light and OPA's Antonio Ciaccia - 10TV Columbus, 10/1/17 *debate featuring OPA Government Affairs Director Antonio Ciaccia
Issue 2 pits emotion against complex drug pricing system - Dayton Daily News, 9/28/17 *OPA opposition discussed
Why Ohio employers should care about Issue 2 - Dayton Business Journal, 9/27/17
Editorial: Issue 2 could drive up price of Ohio drugs - Tribune Chronicle, 9/27/17
Ohio's prescription ballot issue: Get your questions answered - WCPO Cincinnati, 9/26/17
Editorial: Ohio ballot measure does not add up - Parkersburg News and Sentinel, 9/26/17
Editorial: Issue 2 sounds good, but isn’t - Wheeling News-Register, 9/25/17
Editorial: Vote ‘no’ on Ohio’s Issue 2 - Canton Repository, 9/24/17
Norton pharmacist explains pitfalls of Issue 2 - Norton Post, 9/23/17 *OPA member Dan Karant interviewed
Editorial: Reject Issue 2, the drug pricing proposal - Cleveland Plain Dealer, 9/15/17
How truthful is the EpiPen ad put out by the Yes on Issue 2 campaign? - Cleveland 19 News, 9/13/17
America's Work Force Radio show with OPA's Antonio Ciaccia - America's Work Force, 9/12/17 *OPA Government Affairs Director Antonio Ciaccia interviewed
Editorial: Issue 2, all message and too little detail - Akron Beacon Journal, 9/11/17
Outside experts assess Ohio’s ballot issue on prescription-drug prices - Columbus Dispatch, 9/5/17
Foes of Ohio drug-pricing initiative see many side effects for state - Ohio Watchdog, 9/5/17 *featuring comments from OPA Government Affairs Director Antonio Ciaccia
Who is the controversial man behind Ohio's drug price ballot initiative? - Cleveland Plain Dealer, 8/24/17
Drug-price ballot failure in California could mean bad prognosis in Ohio - Toledo Blade, 8/20/17
Ohio “Drug Price Relief Act” Ballot Update - Policy & Medicine, 8/17/17
Opposing the Ohio Drug Price Relief Act - Equitas Health, 8/12/17 *OPA partners Equitas Health explain opposition
Ohio Issue 2 opponent Dale Butland on drug price initiative - This Week in Cincinnati - WCPO, 8/8/17
Side Affects: The Ohio Drug Price Relief Act - Side Affects podcast, 7/27/17 *OPA Past President Jeff Bartone and OPA Government Affairs Director Antonio Ciaccia interviewed
Television ads clash over Ohio Drug Price Relief Act - Toledo Blade, 7/24/17
Editorial: Drug-price measure carries terrible side effects - Columbus Dispatch, 7/23/17
Prescription drug issue on ballot draws criticism - Findlay Courier, 7/18/17
Which side should we believe in battle over Ohio drug prices? - Columbus Dispatch, 6/18/17 *featuring comments from OPA Government Affairs Director Antonio Ciaccia
Ohio’s drug price ballot issue: What’s really going on? - Dayton Daily News, 6/14/17 *OPA opposition discussed
Ohio Chamber of Commerce slams Drug Price Relief Act - Columbus Dispatch, 6/6/17
Ohio Drug Price Relief Act: Who is telling the truth? - 10TV Columbus, 5/25/17 *OPA Government Affairs Director Antonio Ciaccia interviewed
Former Ohio Medicaid directors oppose drug price ballot issue - Cleveland Plain Dealer, 5/23/17
Broad coalition anchored by drug makers opposes Ohio ballot issue - Columbus Dispatch, 5/23/17 *OPA mentioned as key opponent
Drug Price Relief Act sent to Ohio lawmakers for review despite petition fraud concerns - Cleveland Plain Dealer, 2/4/16 *OPA mentioned as key opponent
Drugmakers gearing up for fight on Ohio ballot issue - Columbus Dispatch, 1/17/16 *featuring comments from OPA Executive Director Ernie Boyd